Kirkridge Common Grounds Coffee Kirkridge Peaceful Grounds ...
Kirkridge Retreat Center 2495 Fox Gap Road Bangor, PA 18013 Phone: (610)588-1793
Holiday Gift Basket Order Form Shipping Address Bill to: (address as it appears on credit card statement) Name Street/PO City State Zip Phone Quantity Kirkridge Gift Basket
Total
$34.00
Options to be added to Gift Basket
Kirkridge Common Grounds Coffee
$10.00
Pennsylvania Roasted Organic Fair Trade Coffee Guatemalan Chajul Regular 16 oz.
Kirkridge Peaceful Grounds Coffee
$11.00
Pennsylvania Roasted Organic Fair Trade Coffee Casscadia Decaf 18 oz.
2 Herbal Teas
$8.00
Decaf and regular variety pack
Prayer Beads
$12.72
Truffles only, package of 12
$13.50
Specify Payment Method Check in advance VISA Mastercard Discover
Sub total S & H* Total
Card number Exp date Print name as it appears on card
*Shipping & handling cost on baskets $12.65 or just Truffles $5.95
Holiday Gift Basket Order Form Shipping Address Bill to: (address as it appears on credit card statement) Name Street/PO City State Zip Phone Quantity Kirkridge Gift Basket
Total
$34.00
Options to be added to Gift Basket
Kirkridge Common Grounds Coffee
$10.00
Pennsylvania Roasted Organic Fair Trade Coffee Guatemalan Chajul Regular 16 oz.
Kirkridge Peaceful Grounds Coffee
$11.00
Pennsylvania Roasted Organic Fair Trade Coffee Casscadia Decaf 18 oz.
2 Herbal Teas
$8.00
Decaf and regular variety pack
Prayer Beads
$12.72
Truffles only, package of 12
$13.50
Specify Payment Method Check in advance VISA Mastercard Discover
Sub total S & H* Total
Card number Exp date Print name as it appears on card
*Shipping & handling cost on baskets $12.65 or just Truffles $5.95
