Weekly Special Bakery Order Form

Name*

First NameLast Name

Email*

Confirmation Emailexample@example.com

Phone Number*

Please enter a valid phone number.

Date for Pick-up*

Once your order is submitted, you will be contacted to solidify both date/time pick-up options.

All orders require a 24 hours notice of cancellation for refund to be given. Anything less than a 24 hour notice will be billed for full amount.*

I agree

My Products

Zesty Corn ChipsZippy, Zesty, crunchy . . . addictive! Corn chips that are loaded with a blend of spices; there's no way you can eat just one.

$10.00 Quantity

Total

$0.00

Do you want your cookies with or without raisins?*

With raisins, it's the only way to make an oatmeal cookie!Without raisins, it's the purest form of an oatmeal cookie!

Special Instructions or Questions:*

Please type N/A if not applicable

Please indicate payment type:*

Cash at time of pick upPaypal (grainexchange@outlook.com)

When you select Paypal, if you feel comfortable, you can chose to send payment to "family and friends." I do not transfer funds from Paypal until after pick up. If you utilize Paypal, and needed to cancel according to the above criteria, I will refund your payment or apply the funds to your next order, whichever you prefer.

Grain Exchange operates under Oklahoma's Home Cottage Law and is not inspected or licensed by Oklahoma's State Health Department. Bakery goods are prepared in accordance to the guidelines of Oklahoma's Home Cottage Law. All ingredients are gluten free and baked in a gluten free home kitchen, however, baked goods are not tested, therefore are not being sold as certified gluten free. All ingredients are gluten free but may be created on shared equipment from the manufacturer. While baked goods are gluten free, baked goods may contain other allergens such as corn, dairy, eggs, peanut, tree nuts, and soy.*

I agree