EMPOWERED Cookies and Coffee Order Form
We can’t wait to EMPOWER you with delicious cookies and coffee.
Simply complete one form for each order and we’ll handle the rest.
Feel free to c
ontact us at email@example.com with any questions. And t
hank you for EMPOWERING ovarian cancer research!
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Your mailing address (please include city, state and zip!)
Your email address
Cookies and Coffee Selection
Bag of coffee and at least 6 cookies - $25
Box of coffee and at least 18 cookies - $50
EMPOWER ornament and card only - a donation of $25 or more
To whom are we delivering? (full name, please)
Where should we deliver? (complete address, please, including city, state, and zip)
On which date should we deliver?
Friday, December 16, 2022 (Seattle only)
Sunday, December 18, 2022 (Seattle or Olympia)
What should the tag say? (To whom, from whom? If no information is provided the default will be "Happy Holidays from The Powell-Drescher Foundation")
How would you like to pay?
Make a donation through
and write "empower" in the comments
Mail a check to Powell-Drescher at 12345 Lake City Way NE, #2201, Seattle, WA 98125
Venmo to @Sachia-Powell, if asked the last 4 digits of the phone are 7081 (donating this way will not confer any tax benefit)
(donating this way will not confer any tax benefit)
Send me a copy of my responses.
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