Printable Order Form
*Email information will be used to let you know the next month’s menu and ordering dates/times, if the truck is running late on Distribution Day, or for other Distribution Day updates. It will not be shared or used for any other purpose.
Please Print Clearly
| Name | ___________________________________ |
| Address: | ___________________________________ |
| ___________________________________ | |
| *Email: | ___________________________________ |
| Phone: | (_____) _____-____________ |
| Regular Unit: | ____ @ $30.00 = ____________ |
| Special A: | ____ @ $20.00 = ____________ |
| Special B: | ____ @ $20.00 = ____________ |
| Special C: | ____ @ $20.00 = ____________ |
| Total Amount Due = $_______________ | |
Please Note:
- Check your Calculations — orders with errors will be returned and the order will not be placed until corrected.
- All Mail-in Orders MUST be in the form of a Money Order or Cashiers Check. (Personal Checks NOT ACCEPTED) and must include an Order Form.
- Please Enclose a “Self-addressed-Stamped” envelope for your receipt, which is required to pick up your order.
Make money order/cashiers check payable to “BVCOB -AFM” and mail with this form to:
Angel Food Ministries @
Buffalo Valley Church of the Brethren
46 Brethren Church Road
Mifflinburg, PA 17844