| Check Item |
Cost |
Qty. |
Subtotal |
 Welcome to M.U. |
$19.95 |
_________ |
_________ |
| Trick or Treat |
$14.95 |
_________ |
_________ |
| Finals Package |
$12.95 |
_________ |
_________ |
| Valentine's Day |
$14.95 |
_________ |
_________ |
| Get Well Package |
$12.95 |
_________ |
_________ |
| Balloon Bouquet |
$12.95 |
_________ |
_________ |
| Healthy Snacking |
$14.95 |
_________ |
_________ |
| TV Snack Attack Pack |
$9.95 |
_________ |
_________ |
| 21st Birthday Package |
$12.95 |
_________ |
_________ |
Any Occasion Cake
|
$12.00 |
_________ |
_________ |
| Check desired cake flavor: |
Vanilla |
Chocolate |
Marble |
|
| Cookie Club |
Each Month $8.00
Whole year $40.00
|
_________ |
_________ |
| Check desired month(s): |
October |
November |
December |
|
February |
March |
April All |
|
| Birthday Cake Special |
$19.95 |
_________ |
_________ |
| Check desired cake flavor: |
Vanilla |
Chocolate |
Marble |
|
| Giant Cookie |
$12.00 |
_________ |
_________ |
| Check desired icing flavor: |
Vanilla |
Chocolate |
|
|
| Pizza Party |
$14.50 |
_________ |
_________ |
| Check desired topping: |
Cheese |
Pepperoni |
|
|
| Subtotal |
_________ |
| If order is for 4 or more packages Less 15% |
_________ |
| Total Enclosed |
_________ |
Student Information
| Name: ____________________________________ |
Phone: _______________________________ |
| Address: ____________________________________________________________________________ |
Purchaser Information
| Name: ____________________________________ |
Phone: _______________________________ |
| Address: ____________________________________________________________________________ |
For Visa®, Mastercard® and Discover® Card Customers
| Card Number: ____________________________________________ |
Exp.: ___________________ |
| Visa® |
Discover® |
Mastercard® |
Fax: (717) 871-2412 |
| Signature: _______________________________________________ |
Date: ___________________ |
| Make Checks Payable to: |
Millersville University |
| Send Check or Money Order to: |
Shops & Services
Millersville University
P.O. Box 1002
Millersville, PA 17551-0302
|
| Delivery Date(s) _____________________________________________________________________ |
Card Messages
| _____________________________________________________________________________________ |
| _____________________________________________________________________________________ |
|
