KAIROS Fundraiser Dessert Order
Full Name
First Name
Last Name
E-mail
Contact Number
-
Area Code
Phone Number
I am ordering for myself and this is my address:
Address (In Modesto, CA (or within 20 miles )
I am ordering for a friend or family member and this is his/her address
Address (In Modesto, CA ( or within 20 miles)
Desserts I am ordering
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The Eclair Pair
$
20.00
One pair of 5 inch eclairs: Vanilla Bean and Coffee
Quantity
1
2
3
4
5
6
7
8
9
10
The Petite Pumpkin Cheesecake (3 inch)
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
An entire 8 inch Pumpkin Cheesecake
$
45.00
Which feeds 6 or more
Quantity
1
2
3
4
5
6
7
8
9
10
4 of the Eclair Pair
$
70.00
4 of the Petite Cheesecakes
$
70.00
5 of the Eclair Pair
$
80.00
5 of the Petite Cheesecakes
$
80.00
Total
$
0.00
Please deliver on Thursday Oct. 22
Between 4 p.m. and 6 p.m.
Between 6 p.m. and 8 p.m.
Please deliver on Friday Oct. 23
Between 4 p.m. and 6 p.m.
Between 6 p.m. and 8 p.m.
Please deliver on Saturday Oct. 24
Between 4 p.m. and 6 p.m.
Between 6 p.m. and 8 p.m.
I would like to pick up the dessert(s). Please email me to give me a specific location.
I will pick up on Thursday
I will pick up on Friday
I will pick up on Saturday
Additional Comments
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