Beef on a Bun Order Form

Beef on a Bun September 18, 2025

To place your order, please fill in the form below.
Home roasted beef on a fluffy bun, served with fresh coleslaw, homemade cake and a banana

Have it delivered to you in Goderich, Clinton, Seaforth, and Wingham
Full Name*

PrefixFirst NameLast Name
Company Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Lunch $12.00
Number of lunches*
Total $ (# of lunches x $12)*
Payment Options - Pre-paid meals are encouraged. Payments must be received by September 12 unless payment is being provided upon delivery. Thank You!

Cheque will be mailed - Payable to Alzheimer Society Huron Perth, 317 Huron Road Box 639 Clinton, ON N0M 1L0Credit payment - Call the office to make payment 519-482-1482E-Transfer to cathyr@alzhp.ca - Please put your Business Name and town in the notes when sending throughCash or cheque will be provided upon pick-up or delivery of meal(s)Payment will be dropped off to the Alzheimer Society Huron Perth office in Clinton between 9:00 am and 4:30 pm, Monday to Friday.
Pick up or Drop off of Meal

We will pick up - St.Peter's Catholic Church 156 North St. Goderich. Pick up between 11:00 am and 12:30 pm on September 18.Please deliver to our location. Please note any special instructions below.
Delivery Instructions: Please state which door, if there is a counter/table to place it on, etc.
Thank you for your support!
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Beef on a Bun September 18, 2025