Burke's Bakery Custom Cookie Request Form
Would you like your order to be picked up or shipped?
*
Pick-up (Lexingon, KY - Hamburg)
Pick-up (Winchester, KY)
Shipping
Customer Information
Customer's Name
*
First Name
Last Name
Customer's Phone Number
*
Please enter a valid phone number.
Customer's Email
*
example@example.com
For shipped orders, where do you want to send the cookies? (Shipping Address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about Burke's Bakery?
Order Details
How many cookies are you interested in ordering? There is a minimum 12 cookie requirement.
*
Date cookies are needed
*
-
Month
-
Day
Year
Date
What theme would you like for your cookies? Describe it here as detailed as possible.
*
Optional: Upload any inspiration photos here.
Browse Files
Drag and drop files here
Choose a file
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of
Important Reminders
I understand that this is just an inquiry. This doesn't confirm my order. A follow up e-mail be with sent to the e-mail provided.
I understand that full payment is required to reserve my order on Burke's Bakery's calendar and that I won't be able to pay day of pick-up.
I understand that if I am unable to keep my scheduled order, I will notify you immediately. Orders canceled prior to two weeks before your order date will be refunded in full. Orders cancelled within two weeks of the due date will not receive a refund.
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