Holiday Boxes - Online Order Form

Agency Name
Agency Number
Contact Person / Phone
Choose One	Deliver Pick up
Delivery Location	Choose Drop Site Pick Up at Food Bank Alpena Atlanta Augres Bay City Caro Cheboygan Gaylord Grayling Harrisville Houghton Lake Imlay City Indian River Marlette Midland Mio Omer Pinconning Port Huron Prudenville Saginaw Tawas West Branch
Number of Holiday Package(s) #1 @ $33.00 ea.
Number of Holiday Package(s) #2  @ $38.00 ea.
Building Box C- Holiday Kits	24 Boxes $240.00 48 Boxes $480.00 72 Boxes $720.00 96 Boxes $960.00 120 Boxes $1200.00 144 Boxes $1440.00  Need more than 144? enter #: (Must be in increments of 24)
Cut-off Ordering Thanksgiving Boxes is:       November 14, 2008 Cut-off Ordering Christmas Boxes is:           December 12, 2008	Cut-off for all delivery orders is two days prior to date of delivery