Hotel Chocolat US Tasting Room Survey

Thank you for your interest in our chocolate tasting and cocoa discovery experiences. Please provide us with the following information and one of our team members will contact you to confirm arrangements.

Thank you for your interest in our chocolate tasting and cocoa discovery experiences. Please provide us with the following information and one of our team members will contact you to confirm arrangements. Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

Desired Time

Desired Time 12PM

3PM

6PM

Date(s) Available

Can be a little earlier / later

Must be exactly this time

	None	1	2	3	4	5	6	7	8 (max)
Number of Guests	Number of Guests None	Number of Guests 1	Number of Guests 2	Number of Guests 3	Number of Guests 4	Number of Guests 5	Number of Guests 6	Number of Guests 7	Number of Guests 8 (max)

Tasting Menu

Tasting Menu Chocolate

Chocolate & Chili Adventure (limited time offer)

Chocolate Preference (tick all that apply)

Chocolate Preference (tick all that apply) Milk chocolate

Dark chocolate