Friday Order Form

Your Contact Information

First Name *

Last Name *

Email Address *

Phone number

Gifts

Donate fresh Four Worlds Bakery bread to local food pantries serving the homeless, the unemployed, the struggling single parents, to those who don't even know where their next meal is coming from. Through a partnership with the Hunger Coalition, your contribution can be tax deductible (email for details). Make a selection:

Gift Certificates. Purchase gift certificates in $36 increments and for each $36 you get $40 in credit for your beneficiary.

Beneficiary information. Please give us the first and last name of your intended beneficiary and we will immediately open their buyers club account. Please leave a comment if you want us to issue a paper certificate to you or directly to your intended beneficiary.

Bagels

Everything Bagel(s)

Sesame Bagel(s)

Poppy Bagel(s)

Cinnamon Raisin Bagel(s)(+ $.25 ea.)

Plain Bagel(s)

Quanitity Discount: Enter how many dozen bagels you have entered above.

Total $ Bagel Order

Challah

Whole Wheat Challah (enter quantities to order)

WW Challah Loaf with Poppy ($6)

WW Challah Loaf with Sesame ($6)

WW Challah Loaf with No Seeds ($6)

WW Challah Loaf with Raisins & No Seeds ($7)

WW Challah Rolls($1 ea.)

Click here for no egg wash NoEgg

Whole Wheat Challah $ Total

Egg Challah (enter quantities to order)

Egg Challah Loaf with Poppy ($6)

Egg Challah Loaf with Sesame ($6)

Egg Challah Loaf with No Seeds ($6)

Egg Challah Loaf with Raisins & No Seeds ($7)

Egg Challah Rolls($1 ea.)

Egg Challah $ Total

Spelt Challah has been discontinued

Total $ for Challah Order

Babka

Chocolate Spelt Babka: $12/35oz. loaf ($6/half loaf). Select how many loaves you want:

Total Babka Order

Croissant

Plain Croissant ($1.25 ea.)

Chocolate Croissant ($1.5 ea)

Raisin Croissant. Shaped like a danish roll, and filled with vanilla pastry cream and raisins. ($1.5 ea.)

Almond Croissant. A regular croissant filled with a delightful made-from-scratch almond cream; topped with sliced almonds. ($2 ea.)

Goat Cheese Croissant: a regular croissant filled with a local goat cheese and topped with shredded Guyere

**Answer Required: How many total croissant did you order? *

Click here to get your $3 discount $3 discount

Total $ Croissant Order

Bread

Whole Wheat Levain (w/Sesame) ($4.50 per 1.5 lb loaf). Enter number of loaves.

Cranberry Walnut Levain ($6.25 per 1.5 lb loaf). Enter number of loaves.

Olive Rosemary Levain ($6.25 per 1.5 lb loaf). Enter number of loaves.

French Baguette ($3 per loaf). Enter number of loaves.

Pan Levain (White Sourdough) ($4.25 per 1.5 lb. loaf). Enter number of loaves.

Multigrain Levain ($5 per loaf). Enter number of loaves.

Total Bread Order $

Granola. $3.25 for .5 lb; $6/lb. Select number of pounds:

Delivery Information

For pickup, ordering, and payment instructions please visit the web page at http://fourworldsbakery.vpweb.com/Ordering.html.

This Order is for delivery on: *

Packaging Options *

I want my order delivered to: (Specific P/U locations, addresses, times to pick up and other details are on the webpage ordering section: www.fourworldsbakery.com; for special requests, leave a comment on the bottom of the form). *

Loaf Packaging Options. Selections include packaging for all the loaves in this order. (babka cannot be pre-sliced b/c the chocolate sticks to the machine blades).

Payment Options

Here is your total for this order

I will pay by: (Note: No obligation to pay until you get your order) *

Optional: Recharge my account in the following amount:

You will get a credit of $40 for every $36 you pay. Please start my Buyers Club account with

I will pay by: *

Total charges to add credit to your Buyers Club Account (total for this week's delivery will be deducted from your account)

Additional Comments

Include here any additional comments or special ordering requests

Feedback Comments

Please give me feedback on prior orders here. What did you like and how can the products be improved?

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