To place an order, please print this order form by clicking here, complete the form, and then fax to to us.

ORDER FORM BENEDICTINE MONASTERY ALTAR BREAD DEPT. 4103 VT RTE 100 WESTFIELD, VT 05874

E-MAIL altarbread@ihmwestfield.com

PHONE: (802) 744-6525

FAX: (802) 744-6236

Ship to:

Phone:

Address:

City:

State:

ZIP:

THIN WHITE HOSTS

THIN WHOLE WHEAT HOSTS

1 ^1/8"

$12.60/1,000

1 ^1/8"

$13.40/1,000

1 ^3/8"

$14.30/1,000

1 ^3/8"

$15.40/1,000

2 ¾"

$ 4.40/50

2 ¾"

$ 5.00/50

2 ¾" scored

$ 5.00/50

2 ¾" scored

$ 5.50/50

4 ¾" scored

$ 4.40/10

5 ½" scored

$ 5.20/10

THICK GOLDEN WHOLE WHEAT HOSTS

small 1 ^3/8"

$14.30/500

large 2 ¾"

$ 4.40/25

large 4 ½"

$ 9.60/25

large 5 ¼"

$ 7.70/12

Handling ($1.50 per box for orders $50.00 and under; $2.00 for orders over $50.00). Shipping charges will be added to each order.

Please send by: U.S. Mail______

OR U.P.S._____________

OR Priority Mail___________

Deliver every month_____

every 2 months_____

every 3 months_____

other________

THANK YOU FOR SUPPORTING OUR BENEDICTINE CONTEMPLATIVE COMMUNITY.