Masa Cooperativa Pre-Order Form
Pre-order form for pickup at Headhouse Market on Nov. 27 
Check us out at masa.coop 
Sign in to Google to save your progress. Learn more
What is your name?
Please provide your phone number (to contact you for questions about your order)
Your Order (scroll down for ingredients)
Order
Color - White Corn
Color - Blue Corn
Color - Red Corn
Quantity - 1
Quantity - 2
Quantity - 3
Quantity - 4
Tortillas ($8) - 1 dozen (choose color)
Masa ($7) - 1 kilo (choose color)
Chips ($8) - 250 grams (mixed colors only)
Red Salsa (spicy) ($5) - 8 oz
Green Salsa (mild) ($5) - 8 oz
Guacamole ($10) - 8 oz
Any comments on your order
PRODUCT INGREDIENTS 
All made in Philadelphia, PA
TORTILLAS. Nixtamalized organic corn, water.
MASA (dough to make your own). Nixtamalized organic corn, water.
CHIPS. Nixtamalized organic corn, water, canola oil.
RED SALSA. Red chiles (morita, guajillo, árbol), jalapeño, onion, and garlic.
GREEN SALSA. Tomatillos, jalapeño, onion, and garlic.
GUACAMOLE. Avocado, lime, cilantro, onion, and salt.





Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms