fill out an order form

BRING BACK THE “MAY DAY” TRADITION!
TREAT YOUR SPECIAL SOMEONE TO THIS AWESOME “MAY DAY” BASKET
THIS BASKET CONTAINS:
(1) SMALL BAG OF KOATED KERNELS “DOUBLE CHEDDAR”
(1) SMALL BAG OF KOATED KERNELS “SEA SALT CARAMEL”
(1) SMALL DECORATIVE BAG OF a ½ lb. OF PALMER CANDY SPRINGTHEMED CANDY COATED CHOCOLATE “GEMS”
(1) “Happy May Day” card for you to personalize
YOUR COST=$15.00
Pick up location: Jolly Time Koated Kernels, 1717 Terminal Drive, Sioux City, IA 51105
Pick up times: Thursday, April 27th and Friday, April 28th from 11:00 a.m. –1:30 p.m.
** If you are not able to pick up on these dates your basket will be available on
Saturday, April 29th from 10:00 a.m. until Noon
TREAT THAT TERRIFIC MOTHER OR GRANDMOTHER TO A TREAT
WITH THIS SPECIAL “MOTHER’S DAY” BASKET
THIS BASKET CONTAINS:
(1) SMALL BAG OF KOATED KERNELS “CINNAMON ROLL”
(1) SMALL BAG OF KOATED KERNELS “CHEDDAR CHEESE”
(1) SMALL BAG OF KOATED KERNELS “CLASSIC CARAMEL”
(1) PALMER CANDY HOME-MADE “ SEA SALT CARAMEL TRUFFLE”
(1) 8.4 oz. BOTTLE OF MARTINELLI’S “SPARKLING CIDER”
(1) “Happy Mother’s Day” card for you to personalize
YOUR COST=$25.00
Pick up location: Jolly Time Koated Kernels, 1717 Terminal Drive, Sioux City, IA 51105
Pick up times: Thursday, May 11th and Friday, May 12th from 11:00 a.m. –1:30 p.m.
** If you are not able to pick up on these dates your basket will be available on
Saturday, May 13th from 10:00 a.m. until Noon
TREAT THAT TERRIFIC FATHER OR GRANDFATHER TO A TREAT
WITH THIS SPECIAL “FATHER’S DAY” BASKET
THIS BASKET CONTAINS:
(1) SMALL BAG OF KOATED KERNELS “CHEDDAR JALAPENO”
(1) SMALL BAG OF KOATED KERNELS “BLACK & WHITE”
(chocolate-y base crowned with decadent white chocolate )
(1) SMALL BAG OF KOATED KERNELS “MIDWEST MIX”
(caramel & cheddar)
(1) 3 oz. BAG OF BEER NUTS “ORIGINAL PEANUTS”
(1) 12 oz. BOTTLE OF “DAD’S “OLD FASHIONED ROOT BEER”
(1) “Happy Father’s Day” card for you to personalize
YOUR COST=$25.00
Pick up location: Jolly Time Koated Kernels, 1717 Terminal Drive, Sioux City, IA 51105
Pick up times: Thursday, June 15th and Friday, June 16th from 11:00 a.m. –1:30 p.m.
** If you are not able to pick up on these dates your basket will be available on
Saturday, June 17th from 10:00 a.m. until Noon
FLIP OVER TO ORDER →
NAME:____________________________________________________
ADDRESS:_________________________________________________
PHONE NUMBER:___________________________________________
E-MAIL:____________________________________________________
I WOULD LIKE TO ORDER THE FOLLOWING:
__________ MAY DAY BASKET(s) @ $15.00 each = $_____________
__________ MOTHER’S DAY BASKET(s) @ $25.00 each = $__________
__________ FATHER’S DAY BASKET(s) @ $25.00 each = $___________
___________ TOTAL # OF BASKETS
TOTAL AMOUNT DUE = $________
______Check Enclosed
______Credit Card Type: MC___Visa____American Express____Discover____
Account #___________________________________
Expiration Date:___________CVV:________
Signature: ____________________________
Please send this form and your check or credit card information to:
CSADV, PO Box 1565, Sioux City, IA 51102
OR CALL TO ORDER: Misty @ 712-277-0131
OR E-MAIL YOUR ORDER: [email protected]
YOUR PURCHASE WILL HELP THOSE WE SERVE AT CSADV