Cookie order form || Youth Group

Please fill out this form to place your order for cookies. All proceeds will go to sponsor and fund the Youth Retreat in August. If you encounter any issues while attempting to order, or require any assistance, please email Ben Ewen at citygroups@gracepasadena.org. Thank you for supporting the youth of Grace Pasadena!

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This form cannot be submitted until an administrator completes the setup process to receive online payments.

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

How would you like to receive you order? At church, or delivered to your home?

*

Please select one option.

Pick up at church Hand delivered in person at my home

How many bags of cookies would you like to order? ($5/bag)

*

Please select one option.

1 bag ($5) 2 bags ($10) 3 bags ($15) 4 bags ($20) 5 bags ($25)

Payment

1 bag ($5) 2 bags ($10) 3 bags ($15) 4 bags ($20) 5 bags ($25) I just want to donate ($)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form to place your order for cookies. All proceeds will go to sponsor and fund the Youth Retreat in August. If you encounter any issues while attempting to order, or require any assistance, please email Ben Ewen at citygroups@gracepasadena.org. Thank you for supporting the youth of Grace Pasadena!

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