fundraising for: checks payable to: Freshly Roasted Coffee $12 per bag $ 12 Artisan Loose Tea $ 4 Cocoa-Chai Biscotti Gifts Ground Coffee Whole $12 per bag $12 $10 $10 $9 $26 $39 Harmony Decaf Sunrise Breakfast Heritage Blend BOLD Reserve Hazelnut Crème Pumpkin Spice Choc-Raspberry Vanilla Nut Caramel Crème Harmony Decaf Sunrise Breakfast Heritage Blend BOLD Reserve CLEVER CUPS -3 Earl Grey Welsh Morning Green T Mango Prairie Passion Organic Black Organic Green Berry Basket Montana Gold T-Infuser Spoon Ghana Cocoa GB Rich Cocoa Chai Latte Choc-Espresso Choc-Hazelnut Classic Gift pack Deluxe Gift pack Total Items Total Due Name and address. G G G G G G G G G W W W W Caf- Free Caf- Free Example Jones/325 Samson St. 2 2 1 5 57 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Please add up your TOTALS HERE > A B C D E F G H I J K L M N O P Q R S T U V W X Y Z AA BB CC DD Seller Name ______________________________________________ ORDERS DUE: (Orders ship 5-10 days after due date) INSTRUCTIONS: Your Total Collected ______ Short/Over $_______ Extra Donations $_______ [email protected] 1-800-985-8075 rev 9.13