Our Lady of the Lakes Parish

West Deer Township (Russellton / Bairdford), Pennsylvania

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Nut Roll Order Form

- We have sold out! This form is no longer accepting orders.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email Please enter an email address.
  
  Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Thank you for your order! Please specify quantities and pick-up times below. Payment is due when you pick up your order. Cash, check, and credit cards will be accepted.
  
  Number of Nut-filled Rolls -- $15 each ----------- (enter 0 if none are requested) REQUIRED Please fill out this field. Please enter an integer (number).
  
  Number of Apricot-filled Rolls -- $15 each -------- (enter 0 if none are requested) REQUIRED Please fill out this field. Please enter an integer (number).
  
  TOTAL NUMBER OF ROLLS (Enter total quantity of BOTH Nut-filled + Apricot-filled below) REQUIRED Maximum 240 characters
  240 remaining
  Please fill out this field. Please enter an integer (number) from 1 to 240.
  
  Select your pick-up time and location REQUIRED Please fill out this field.
  
  I agree that I will pay for and pick up my nut roll order at my selected time and location. I understand that my nut roll order will not be available in the other time slots.
  I Agree Please select this field.
  
  Submit