Prepaid Subscription Delivery Order Form

Choose one of these 3 options:

Store Credit: You pay for a store credit. Order whenever you are needing dairy from your account on our website; using your store credit coupon.

Weekly Subscriptions: Select any products you want us to deliver to your home or workplace every week. Your order will be reoccuring.

Both: Sign up for a reoccuring weekly subscription plus buy store credit for any extra dairy you might need. The best of both worlds!

FREE Delivery options:

Buy $1000 or more of store credit,

Or sign up for a weekly subscription for $50 or more.

Check Box For Store Credit

Check Box For Weekly Dairy Subscription

STORE CREDIT

This prepaid feature is perfect for you if you prefer to order several times a month instead of every week. Pay store credit at the farm store & then order your preferred products however often you would like!

A $10/delivery fee will be deducted from your store credit each time you order.

Buy $1000 or more of store credit & get FREE delivery!

Or Use store credit to order add-ons to your weekly dairy subscriptions. (More details below.)

We will send you an order reminder with a link to our online store each weekend. Have your orders in by Monday @ noon.

You can prepay any $ amount. We recommend enough for 12 weeks. You can replenish this account at any time you are at the farm store.

Please be prepared to pay this amount at the farm store.

My store credit amount I want added to my account:

Store Credit (Tax will also be added when you pay)

WEEKLY Dairy SUBSCRIPTION

Choose the items you need for your family each week.

This will be a standard reoccuring order for 12 weeks.

Buy $50/weekly & get FREE delivery!

(We will waver delivery fee at the time of payment if you qualify!)

Grass-fed Raw Dairy Products + Eggs + Ground Beef & Pork

MilkCheck box to see different size options.

$12.00

	Quantity	Price
Fresh 1 Gallon		$12.00
Fresh 1/2 Gallon		$6.25
Frozen 1 Gallon		$12.50
Frozen 1/2 gallon		$6.75
Fresh 12 oz.		$2.00

Item subtotal:$0.00

CreamCheck box to see different size options.

$14.50

	Quantity	Price
Pint in plastic container		$14.50
Pint in glass jar		$15.00

Item subtotal:$0.00

Chocolate MilkCheck box to see different size options.

$3.50

	Quantity	Price
12 oz.		$3.50
1/2 gallon		$13.50
1 gallon		$26.00

Item subtotal:$0.00

ButterCheck box to see different size options.

$24.00

	Quantity	Price
Salted 14 oz.		$24.00
Unsalted 14 oz.		$24.00
Salted 7 oz.		$12.50
Unsalted 7 oz.		$12.50

Item subtotal:$0.00

Honey & Vanilla Yogurt1 qt.

$9.00 Quantity
Item subtotal:$0.00

Cottage Cheese1 pt.

$5.00 Quantity
Item subtotal:$0.00

Greek YogurtCheck box to see different flavor options.

$7.50

	Quantity	Price
Honey & Vanilla (1pt.)		$7.50
Plain (1pt.)		$6.25

Item subtotal:$0.00

KefirCheck the box to see different size options.

$6.50

	Quantity	Price
1 quart		$6.50
1/2 gallon		$12.00

Item subtotal:$0.00

Cheddar CheeseCheck box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Farmstead CheeseCheck box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Garlic Dill CheeseCheck box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Jalapeno Cheddar CheeseCheck box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Italian Cheddar Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Kefir Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Marble Cheese 1 lb.

$15.00 Quantity
Item subtotal:$0.00

Smokey Cheddar Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Smokey Paprika Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Swiss Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Tomato Basil Cheddar Cheese Check box to see different size options.

$15.00

	Quantity	Price
1 lb.		$15.00
.75 lb.		$11.25
1.25 lb.		$18.75

Item subtotal:$0.00

Cheese CurdsCheck box to see different options.

$7.50

	Quantity	Price
Cheddar Cheese Curds 8 oz.		$7.50
Jalepeño Cheese Curds 8 oz.		$7.50

Item subtotal:$0.00

Mozzarella Cheese Sticks4 oz. 4 sticks

$5.00 Quantity

Shredded Mozzarella1 lb.

$15.00 Quantity
Item subtotal:$0.00

Eggs1 dozen

$8.00 Quantity
Item subtotal:$0.00

Ground Beef1 lb.

$9.00 Quantity
Item subtotal:$0.00

Ground Pork1 lb.

$7.50 Quantity
Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Take the total x 12 for the grand total due.
This total is the 12-week subscription you will pay when you come to the farm store. (We will waver delivery fee at the time of payment if you qualify for FREE delivery!)

Name*

First NameLast Name

Address- Use address where you would like to have your ordered delivered*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Agreement For Contract:

Due to KS state raw milk laws, I understand that I need to pay all raw dairy products on-farm. I agree to make this transaction in person at Borntrager Dairy.

KS state law states: '"On-farm retail sales of milk or milk products" means the sale of milk or milk products on the farm by the producer from the production of the dairy herd to the final consumer.' (KDA website)

SIGNATURE

Prepaid Delivery Order Form