MOTHER CLUSTERS ORDER FORM
For large orders (5 or more different types of clusters), please email us directly at info@mother-clusters.com.
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
What date do you need your order by?
*
-
Month
-
Day
Year
Date
How did you hear about Mother Clusters?
Is this order for a special occasion? Tell us about it!
If you have a promo code, you may enter it here (one use per clustermer):
What day(s) of the week is best for you to pickup your order (check all that apply)?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What time of the day is best for you to pickup your order (check all that apply)?
*
Morning
Afternoon
Evening after 5pm
CHOOSE YOUR FIRST CLUSTER:
*
Custom Cluster (build your own!), $30 base/lb
Classic Mother Cluster
Awkward Sea Turtle
Coconutsy
Fruit & Nut Case
Hyped Up
Lean Mean Cookies & Cream
Rocky Whoa'd
Movie Theater Floor
S'moreo
The B.S.'er
Turn That Frownie to a Brownie
S'more of What?
Specialty, Seasonal, or Holiday Cluster (please specify which flavor below)
Please specify here:
Choose how many pounds you would like:
*
1 LB
2 LB
3 LB
Other
Please specify:
Choose which size you would like:
*
Little Mother Cluster (+$2/lb)
Basic Mother Cluster
Colossal Cluster
Please list any ingredients you would like to remove from your cluster, if applicable:
What flavor would you like (click all that apply)?
*
Whichever the cluster already comes with
Milk Chocolate
Dark Chocolate
White Chocolate
Would you like to add an additional flavor?
Peanut Butter ($2.00/lb)
Salted Caramel ($2.00/lb)
Raspberry ($1.00/lb)
Strawberry ($1.00/lb)
Mint Chocolate Chip ($1.00/lb)
Peppermint ($1.00/lb)
CHOOSE YOUR MIX-INS (price per lb)
Sprinkles ($2.00)
Mini Marshmallows ($2.00)
Peanuts ($2.00)
Dehydrated Marshmallow Bits ($2.00)
Popcorn ($2.00)
Potato Chips ($2.00)
Banana Chips ($2.00)
Caramel Bits ($2.00)
Coconut ($2.00)
Pretzels ($2.00)
Graham Crackers ($2.00)
Pecans ($2.00)
Pumpkin Seeds ($2.00)
Dried Cranberries ($2.00)
Raisins ($2.00)
Dried Cherries ($2.00)
Dried Apricots ($2.00)
Dried Pineapple ($2.00)
Prunes ($2.00)
Cheerios ($2.00)
Coffee ($2.00)
Gummy Bears ($3.00)
Cashews ($3.00)
Walnuts ($3.00)
Almonds ($3.00)
Brazil Nuts ($3.00)
Hazelnuts ($3.00)
Dates ($3.00)
Dried Figs ($3.00)
Dried Mango ($3.00)
Chocolate Chip Cookies ($3.00)
Oreo Cookies ($3.00)
Pistachios ($4.00)
Macadamia Nuts ($4.00)
Pine Nuts ($4.00)
Other (Please ask us if we can accommodate)
If you chose other, please specify:
Please let us know of any special requests:
Please list any allergies:
Would you like to add a Mother Clusters logo sticker or car magnet to your order?
Sticker ($2)
Car Magnet ($4)
Please type in how many of each you would like:
WOULD YOU LIKE ANOTHER CLUSTER?
*
YES, PLEASE!
NO, THANKS!
CHOOSE YOUR SECOND CLUSTER:
*
Custom Cluster (build your own!), $30 base/lb
Classic Mother Cluster
Awkward Sea Turtle
Coconutsy
Fruit & Nut Case
Hyped Up
Lean Mean Cookies & Cream
Rocky Whoa'd
Movie Theater Floor
S'moreo
The B.S.'er
Turn That Frownie to a Brownie
S'more of What?
Specialty, Seasonal, or Holiday Cluster (please specify which flavor below)
Please specify here:
Choose how many pounds you would like:
*
1 LB
2 LB
3 LB
Other
Please specify:
Choose which size you would like:
*
Little Mother Cluster (+$2/lb)
Basic Mother Cluster
Colossal Cluster
Please list any ingredients you would like to remove from your cluster, if applicable:
What flavor would you like (click all that apply)?
*
Whichever the cluster already comes with
Milk Chocolate
Dark Chocolate
White Chocolate
Would you like to add an additional flavor?
Peanut Butter ($2.00/lb)
Salted Caramel ($2.00/lb)
Raspberry ($1.00/lb)
Strawberry ($1.00/lb)
Mint Chocolate Chip ($1.00/lb)
Peppermint ($1.00/lb)
CHOOSE YOUR MIX-INS (price per lb)
Sprinkles ($2.00)
Mini Marshmallows ($2.00)
Peanuts ($2.00)
Dehydrated Marshmallow Bits ($2.00)
Popcorn ($2.00)
Potato Chips ($2.00)
Banana Chips ($2.00)
Caramel Bits ($2.00)
Coconut ($2.00)
Pretzels ($2.00)
Graham Crackers ($2.00)
Pecans ($2.00)
Pumpkin Seeds ($2.00)
Dried Cranberries ($2.00)
Raisins ($2.00)
Dried Cherries ($2.00)
Dried Apricots ($2.00)
Dried Pineapple ($2.00)
Prunes ($2.00)
Cheerios ($2.00)
Coffee ($2.00)
Gummy Bears ($3.00)
Cashews ($3.00)
Walnuts ($3.00)
Almonds ($3.00)
Brazil Nuts ($3.00)
Hazelnuts ($3.00)
Dates ($3.00)
Dried Figs ($3.00)
Dried Mango ($3.00)
Chocolate Chip Cookies ($3.00)
Oreo Cookies ($3.00)
Pistachios ($4.00)
Macadamia Nuts ($4.00)
Pine Nuts ($4.00)
Other (Please ask us if we can accommodate)
If you chose other, please specify:
Please let us know of any special requests:
Please list any allergies:
WOULD YOU LIKE ANOTHER CLUSTER?
*
YES, PLEASE!
NO, THANKS!
CHOOSE YOUR THIRD CLUSTER:
*
Custom Cluster (build your own!), $30 base/lb
Classic Mother Cluster
Awkward Sea Turtle
Coconutsy
Fruit & Nut Case
Hyped Up
Lean Mean Cookies & Cream
Rocky Whoa'd
Movie Theater Floor
S'moreo
The B.S.'er
Turn That Frownie to a Brownie
S'more of What?
Specialty, Seasonal, or Holiday Cluster (please specify which flavor below)
Please specify here:
Choose how many pounds you would like:
*
1 LB
2 LB
3 LB
Other
Please specify:
Choose which size you would like:
*
Little Mother Cluster (+$2/lb)
Basic Mother Cluster
Colossal Cluster
Please list any ingredients you would like to remove from your cluster, if applicable:
What flavor would you like (click all that apply)?
*
Whichever the cluster already comes with
Milk Chocolate
Dark Chocolate
White Chocolate
Would you like to add an additional flavor?
Peanut Butter ($2.00/lb)
Salted Caramel ($2.00/lb)
Raspberry ($1.00/lb)
Strawberry ($1.00/lb)
Mint Chocolate Chip ($1.00/lb)
Peppermint ($1.00/lb)
CHOOSE YOUR MIX-INS (price per lb)
Sprinkles ($2.00)
Mini Marshmallows ($2.00)
Peanuts ($2.00)
Dehydrated Marshmallow Bits ($2.00)
Popcorn ($2.00)
Potato Chips ($2.00)
Banana Chips ($2.00)
Caramel Bits ($2.00)
Coconut ($2.00)
Pretzels ($2.00)
Graham Crackers ($2.00)
Pecans ($2.00)
Pumpkin Seeds ($2.00)
Dried Cranberries ($2.00)
Raisins ($2.00)
Dried Cherries ($2.00)
Dried Apricots ($2.00)
Dried Pineapple ($2.00)
Prunes ($2.00)
Cheerios ($2.00)
Coffee ($2.00)
Gummy Bears ($3.00)
Cashews ($3.00)
Walnuts ($3.00)
Almonds ($3.00)
Brazil Nuts ($3.00)
Hazelnuts ($3.00)
Dates ($3.00)
Dried Figs ($3.00)
Dried Mango ($3.00)
Chocolate Chip Cookies ($3.00)
Oreo Cookies ($3.00)
Pistachios ($4.00)
Macadamia Nuts ($4.00)
Pine Nuts ($4.00)
Other (Please ask us if we can accommodate)
If you chose other, please specify:
Please let us know of any special requests:
Please list any allergies:
WOULD YOU LIKE ANOTHER CLUSTER?
*
YES, PLEASE!
NO, THANKS!
CHOOSE YOUR FOURTH CLUSTER:
*
Custom Cluster (build your own!), $30 base/lb
Classic Mother Cluster
Awkward Sea Turtle
Coconutsy
Fruit & Nut Case
Hyped Up
Lean Mean Cookies & Cream
Rocky Whoa'd
Movie Theater Floor
S'moreo
The B.S.'er
Turn That Frownie to a Brownie
S'more of What?
Specialty, Seasonal, or Holiday Cluster (please specify which flavor below)
Please specify here:
Choose how many pounds you would like:
*
1 LB
2 LB
3 LB
Other
Please specify:
Choose which size you would like:
*
Little Mother Cluster (+$2/lb)
Basic Mother Cluster
Colossal Cluster
Please list any ingredients you would like to remove from your cluster, if applicable:
What flavor would you like (click all that apply)?
*
Whichever the cluster already comes with
Milk Chocolate
Dark Chocolate
White Chocolate
Would you like to add an additional flavor?
Peanut Butter ($2.00/lb)
Salted Caramel ($2.00/lb)
Raspberry ($1.00/lb)
Strawberry ($1.00/lb)
Mint Chocolate Chip ($1.00/lb)
Peppermint ($1.00/lb)
CHOOSE YOUR MIX-INS (price per lb)
Sprinkles ($2.00)
Mini Marshmallows ($2.00)
Peanuts ($2.00)
Dehydrated Marshmallow Bits ($2.00)
Popcorn ($2.00)
Potato Chips ($2.00)
Banana Chips ($2.00)
Caramel Bits ($2.00)
Coconut ($2.00)
Pretzels ($2.00)
Graham Crackers ($2.00)
Pecans ($2.00)
Pumpkin Seeds ($2.00)
Dried Cranberries ($2.00)
Raisins ($2.00)
Dried Cherries ($2.00)
Dried Apricots ($2.00)
Dried Pineapple ($2.00)
Prunes ($2.00)
Cheerios ($2.00)
Coffee ($2.00)
Gummy Bears ($3.00)
Cashews ($3.00)
Walnuts ($3.00)
Almonds ($3.00)
Brazil Nuts ($3.00)
Hazelnuts ($3.00)
Dates ($3.00)
Dried Figs ($3.00)
Dried Mango ($3.00)
Chocolate Chip Cookies ($3.00)
Oreo Cookies ($3.00)
Pistachios ($4.00)
Macadamia Nuts ($4.00)
Pine Nuts ($4.00)
Other (Please ask us if we can accommodate)
If you chose other, please specify:
Please let us know of any special requests:
Please list any allergies:
WOULD YOU LIKE ANOTHER CLUSTER?
*
YES, PLEASE!
NO, THANKS!
CHOOSE YOUR FIFTH CLUSTER:
*
Custom Cluster (build your own!), $30 base/lb
Classic Mother Cluster
Awkward Sea Turtle
Coconutsy
Fruit & Nut Case
Hyped Up
Lean Mean Cookies & Cream
Rocky Whoa'd
Movie Theater Floor
S'moreo
The B.S.'er
Turn That Frownie to a Brownie
S'more of What?
Specialty, Seasonal, or Holiday Cluster (please specify which flavor below)
Please specify here:
Choose how many pounds you would like:
*
1 LB
2 LB
3 LB
Other
Please specify:
Choose which size you would like:
*
Little Mother Cluster (+$2/lb)
Basic Mother Cluster
Colossal Cluster
Please list any ingredients you would like to remove from your cluster, if applicable:
What flavor would you like (click all that apply)?
*
Whichever the cluster already comes with
Milk Chocolate
Dark Chocolate
White Chocolate
Would you like to add an additional flavor?
Peanut Butter ($2.00/lb)
Salted Caramel ($2.00/lb)
Raspberry ($1.00/lb)
Strawberry ($1.00/lb)
Mint Chocolate Chip ($1.00/lb)
Peppermint ($1.00/lb)
CHOOSE YOUR MIX-INS (price per lb)
Sprinkles ($2.00)
Mini Marshmallows ($2.00)
Peanuts ($2.00)
Dehydrated Marshmallow Bits ($2.00)
Popcorn ($2.00)
Potato Chips ($2.00)
Banana Chips ($2.00)
Caramel Bits ($2.00)
Coconut ($2.00)
Pretzels ($2.00)
Graham Crackers ($2.00)
Pecans ($2.00)
Pumpkin Seeds ($2.00)
Dried Cranberries ($2.00)
Raisins ($2.00)
Dried Cherries ($2.00)
Dried Apricots ($2.00)
Dried Pineapple ($2.00)
Prunes ($2.00)
Cheerios ($2.00)
Coffee ($2.00)
Gummy Bears ($3.00)
Cashews ($3.00)
Walnuts ($3.00)
Almonds ($3.00)
Brazil Nuts ($3.00)
Hazelnuts ($3.00)
Dates ($3.00)
Dried Figs ($3.00)
Dried Mango ($3.00)
Chocolate Chip Cookies ($3.00)
Oreo Cookies ($3.00)
Pistachios ($4.00)
Macadamia Nuts ($4.00)
Pine Nuts ($4.00)
Other (Please ask us if we can accommodate)
If you chose other, please specify:
Please let us know of any special requests:
Please list any allergies:
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