Harriet’s Creations, Inc.

2974 Green Fairway Cove N.

Collierville, TN.  38017

901-854-1104 Phone 

                                                             901-861-3090 Fax        (ordering info)



I do hereby authorize, by my signature and supplied information below, the use of my credit card information on a one-time-only basis for purchasing the cake, or making payment for, the cake, or item which has been discussed with Harriet’s Creations. I further understand that a no-show for pickup of the item being paid for, constitutes a charge to my credit card for the full amount. By making a deposit on a wedding cake to reserve your date, and signing below, you agree to a charge for a cancellation of the order of a minimum of $50.00 for holding your date, and my refusal of other business on that date. This form is for making payments only and not the contract.  You may pay via PayPal.  You will find me under beacake@aol.com.  If you will be on site, payment by Square is also now available for your convenience, after a deposit is made. Please provide detailed information about what you are purchasing or you can email me and ask me to invoice you via PayPal.  Don't forget tax at 9.75%.



(Please Print Clearly in Ink)


Name of Cardholder: __________________________________________


Address: ___________________________________________


City_______________________ State________ Zip________________


Phone: (______)____________________


Type of Card:  Visa, MasterCard, (Circle One)


Card Number________________________________________


Security Code (Last 3 digits on back of card):__________


Expiration Date:____________


Billing Zip Code:____________


Amount $______________

Use as: (Circle One)

CHARGE TO THE CARD in full--Charge to the card- HALF DOWN (remainder to be paid in advance of pickup by one week for novelty cakes.  All wedding cake payments are due two weeks prior to the wedding date.  Please see the contract for information. Each payment made via credit card online, must be accompanied by this form, or either in person as a signature is required for each authorization.  By placing an order today, you are placing an order for a customized cake for your needs only, and agree that minimal changes or additions to the cake, (such as greetings or salutations) will be at no charge. Fondant cakes which you request be made as buttercream, in an effort to save money, will not have the exact same look as a fondant covered cake.  

Signature__________________________________ Date __________________


Date order needed_____________________

Type of cake or item: (Circle One)

Wedding, Novelty, Holiday Special, Anniversary, Religious, Cookies, Mints

Constant Contact Campaign Name Y/N______________________(specify)Which design are you interested in?_________________________________________________

Which size cake? _________________ Cookies ____________________ to serve___________. How did you learn of this? __________

Cake Flavor: _____________________ (Fill In) Filling Flavor: ______________________( $5.00 extra for novelty cakes)

Enroll me in the email notification system for upcoming specials ____Yes ___No

Email address: Please print __________________________________________

Work can commence on receipt of this completed form. You may call in advance to check on my availability. I will respond to your email address to notify you of receipt of the fax. Fax to Harriet’s Creations at 901-861-3090.  You will be required to show a drivers license, and the credit card upon pickup. Pickup location will be e-mailed to you. Please be sure and join my email list online to be notified of special offers and reminders of your upcoming events!

Thanks for choosing Harriet’s Creations!


Harriet beacake@aol.com