Bread Peddler Weekly Order Form - For Saturday December 5, 2020

PLEASE FILL OUT THIS ORDER FORM AND SUBMIT IT NO LATER THAN TUESDAY, DECEMBER 1, AT 6PM.
To place this order on the phone, call 603-528-6864. If we cannot answer your call, please leave a message and we will call you back to take your order.

IMPORTANT: **THIS FORM WILL SEND US YOUR BREAD SELECTIONS BUT YOU WILL NEED TO RETURN TO THE WEBSITE ORDER PAGE AND CLICK ON A PAYMENT OPTION TO COMPLETE THE PURCHASE.**
Saturday, December 5, where would you like to pick up your order? (Choose only 1) *
Required
What types of breads would you like to order this week? In the next section, you can tell us if you want more than one of each bread. (Please Note: our gluten-free breads are made in a licensed residential kitchen where regular wheat-based breads are also produced)
If you want more than one of the breads you selected above, please tell us that here (ex. 2 Caraway Rye, 2 Peasant, 3 packages of Bialys )
This order form cannot do math so it is unable to total up the cost of your purchase. Please manually total up the cost of your breads and bialys now and make a note of that amount. You will need to enter it later when you process your payment.
Your name (it's just for us to contact you)
Your email address (so we can get back to you if needed) *
Your phone number (if we really need to talk to you) Include area code and use dashes (xxx-xxx-xxxx)
After you click on Submit, please return to our website page and select a form of payment to complete the order. Thank you very much for your business.
Submit
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