Printable Order Form

FAX Order Form
Breads and Gift Baskets
Fax Orders to 410 203 2682

              Before ordering, view our daily Baking Schedule for item availability!
              Select Store Pickup or UPS Delivery
                Ellicott City Store Pickup       Pickup Date  _______________ Pickup Time __________
                Ship UPS                               Ship Date _______________
                      Select Shipping Method       UPS Ground   3 Day    2 Day Air    Next Day Air

BREADS	QTY	PRICE	TOTAL	SLICED
Cheddar Parmesan Sandwich Loaf		4.95
Cinnamon Raisin Walnut Sandwich Loaf		4.60
5 Seed Sandwich Loaf		4.65
Garden Herb Sandwich Loaf		4.45
Grains Galore Sandwich Loaf		4.55
Honey Whole Wheat Sandwich Loaf		3.95
Montana White Sandwich Loaf		3.50
Orange Cranberry Pecan Sandwich Loaf		5.25
Spelt Sandwich Loaf		5.95
Dinner Roles	QTY	PRICE	TOTAL	SLICED
Grains Galore - Dozen Dinner rolls		5.45
Total

Jams & Utensils	QTY	PRICE	TOTAL	SLICED
Bread Knife		9.95
"Dual" Spatula		5.95
Set of Two Porcelain Spreaders		4.95
Stonewall Kitchen Wild Maine Blueberry Jam		2.95
Stonewall Kitchen Strawberry Apricot Jam		2.95
Stonewall Kitchen Raspberry Peach Jam		2.95
Total

ROUND BREADS	QTY	PRICE	TOTAL	SLICED
Cheddar Parmesan Round		5.45
Cinnamon Raisin Walnut Round		4.95
5 Seed Round		4.95
Garden Herb Round		4.75
Grains Galore Round		4.85
Honey Whole Wheat Round		4.35
Montana White Round		3.70
Orange Cranberry Pecan Round		5.45
TOTAL

GIFT BASKETS	QTY	PRICE	TOTAL	SLICED
Hostess Treat in a Gift Basket		49.95
Simply Breads/Jams in a Gift Box		28.95
Great crate in a gift wrapped crate		27.95
Honey Whole Wheat & Jam in a Gift Basket		26.49
Grains Galore & Jam in a Gift Basket		26.49
Orange Cranberry Pecan & Jam in a Gift Basket		26.49
Cinnamon Raisin Walnut & Jam in a Gift Basket		26.49
Montana White & Jam in a Gift Basket		26.49
Cinnamon Raisin Walnut in a Gift Bag		10.95
Orange Cranberry Pecan in a Gift Bag		10.95
Honey Whole Wheat in a Gift Bag		10.95
Montana White in a Gift Bag		10.95
TOTAL
GRAND TOTAL

STORE PICKUP ONLY	QTY	PRICE	FLAVOR
Low Fat Muffins	12 12 12		Pumpkin Pumpkin Pecan Call for Daily Fruit Flavor
Quick Dessert Breads	1 1 1		Pumpkin Pumpkin Pecan Call for Daily Fruit Flavor
TOTAL

Billing Information
Name
Address
Address
City
State	__ __	Zip Code	__ __ __ __ __ - __ __ __ __
Home Telephone	__ __ __ - __ __ __ - __ __ __ __
Work Telephone	__ __ __ - __ __ __ - __ __ __ __ ext. _________
Fax	__ __ __ - __ __ __ - __ __ __ __
Email
Credit Card Type	VISA MasterCard American Express
Name on Credit Card
Credit Card Number	__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiration Date	Month: __ __ Year: __ __ __ __
Coupon Code
Shipping Information
Shipping Address: check if same as above, else fill in below.
Name
Address
Address
City
State	__ __	Zip Code	__ __ __ __ __ - __ __ __ __
Home Telephone	__ __ __ - __ __ __ - __ __ __ __
Work Telephone	__ __ __ - __ __ __ - __ __ __ __ ext. _________
Gift Tag	To: ___________________________________________ From: ________________________________________ Message: ________________________________ ________________________________________ ________________________________________

Thank you for your Order! Fax Orders to 410 203 2682

Toll-Free 877-EBREADS (877 327 3237) or 410 203 2221
Email Contact Us
The Breadery 9251 Baltimore National Pike Ellicott City, MD 21042