Fairview The Grace Place

First Name

Last Name

Phone Number

Email

Original or Gluten Free

Number of Cookie Kits

1

2

3

4

Student Supporting or N/A

Any additional comments:

I understand I must pick up my cookies on Wednesday, February 11th OR I am arranging a delivery from a Fairview Youth Student

Yes!

I understand that my order will not be completed until I pay on the link (this page will redirect you after you hit submit)

YES

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