The Grainless Baker Order Form
Order Placed: Date ________ Initials _____
Today’s Date: _________________________________
Order Deadline:
1st Thursday of the month
Next Delivery Date: ~4:00 2nd Friday of Month________
Your Name _______________________________________
Phone _______________ Other Phone _____________
Item Quantity Price * Extended Price
White SandwichBread __________ 5.79 __________
Flax-seed Bread __________ 6.79 _________
Pumpernickle Bread __________ 5.99 __________
Cinnamon Bread __________ 6.79 __________
Hamburger Rolls 6-pack __________ 4.39 __________
Hot Dog Rolls 6-pack __________ 4.39 __________
Hoagie Rolls 4-pack __________ 4.79 __________
Dinner Rolls 6-pack __________ 3.19 __________
Bagels- Plain __________ 5.29 __________
Blueberry Muffins 4-pack __________ 5.79 __________
Corn Muffins 4-pack __________ 4.89 __________
Choc. Chip Muffins 4-pk __________ 4.89 __________
Muffin Sample Pack __________ 4.89 __________
LP, CC, BB, Ban
Frosted Cinnamon Bun 4-pk __________ 5.59 __________
Almond Biscotti 8 oz bag __________ 5.39 __________
Anise Biscotti 8 oz bag __________ 5.39 __________
Graham Crackers 8 oz. __________ 6.39 __________
Other __________ ____ __________
Other __________ ____ __________
Fresh Pie __________ 9.79 __________
7" Birthday Cake __________ 9.99 __________
Please Inquire about pie and cake types
prices are subject to change*
Total # Items Ordered _________ Total Price _______________
Last updated 10/09
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CUSTOMER RECEIPT: YOUR GRAINLESS BAKER ORDER WILL ARRIVE BY ~4:00 THE AFTERNOON OF THE SECOND FRIDAY OF THE MONTH:
BECAUSE OF THE PERISHABILLITY OF THE PRODUCT,
YOUR ORDER MUST BE PICKED UP BY 7:00 PM SATURDAY. Thank You!
3040 Whitney Ave. Hamden 407-8128
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