2023 Pre-Order Form

2023 Smile Cookie Pre-Order Form

From May 1 to 7, Tim Hortons Restaurant Owners will be supporting more than 600 local charities, hospitals and community programs across Canada. Guests who purchase a freshly baked Smile Cookie will be donating to these great causes with 100% of the proceeds going to the local charity—in our town that is Heartland Hospice Moose Jaw! To pre-order cookies complete this form and email to smile@hhmj.ca or phone info to (306) 690-8699. Cookies are $1.50 each, orders of 6 cookies or more don’t pay tax, so it is $18.00 for a box. Pre-orders are minimum one box. And if you order 3 boxes or more we will deliver them within town for FREE! Pre-orders must be made a minimum of 24 hours ahead of time, 48 is preferred. Last day to pre-order is May 6. Don’t forget to share your smile, by posting a pic with your cookie on Facebook or Instagram during Smile Cookie week using the hashtag #smilecookieMJ
Full Name or Business Name

First NameLast Name
Contact Number*
E-mail*
example@example.com
Pickup or Delivery

Southside (894 Lillooet St W)Downtown (908 Main St N)North End (461 Diefenbaker Dr)Delivery ** for qty larger than three dozen ** Please specify a delivery address in the field below.
Delivery Address

Street Address

Street Address Line 2

CityProvince

Zip Code
When would you like to receive your delivery? (9am-4pm)

MonthDayYear
Date
Hour MinutesAM/PM Option
When would you like the cookies to be available for pickup (9am-4pm)*

MonthDayYear
Date
Hour MinutesAM/PM Option

Order Form*

Box of Smile CookiesContains: 1 Box (12 cookies) Smile Cookie -- Get a Smile. Give a Smile

$18.00CAD Quantity
Item subtotal:$0.00CAD

DonationDonate to Heartland Hospice Moose Jaw!

$ FreeCAD
Item subtotal:$0.00CAD

Total

$0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

If you have any additional notes about this order, please fill out the box below.
To learn more about Heartland Hospice and our goal to create an end of live haven in Moose Jaw go to https://heartlandhospicemj.ca or find us on Social Media by clicking the links below.

Facebook: https://www.facebook.com/heartlandhospicemj

Instagram: https://www.instagram.com/heartlandhospicemj/

Twitter: https://twitter.com/HospiceMj

Youtube: https://www.youtube.com/@HeartlandHospiceMJ
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2023 Smile Cookie Pre-Order Form