Open seven days a week  7 am 
Bagel Shop  open daily 7:00 am





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Order Form
Print this out and fax to (949) 493-1730


**Grinds:   FP = French Press *Grind  |  D=Drip  |  GD=Gold Filter |  E=Espresso

Espresso Roast  Lbs Whole or Ground **Grind
Espresso Roast Decaf.  Lbs Whole or Ground *Grind
French Roast Lbs Whole or Ground *Grind
Vienna Roast Lbs Whole or Ground *Grind
Golden Pecan Lbs Whole or Ground *Grind
House Blend Fancy Lbs Whole or Ground *Grind
House Blend Fancy Decaf. Lbs Whole or Ground *Grind
Colombian Supremo Lbs Whole or Ground *Grind
Colombian Supremo Decaf. Lbs Whole or Ground *Grind
Sumatra Mandheling Lbs Whole or Ground *Grind
Sumatra Mandheling Decaf. Lbs Whole or Ground *Grind
Vanilla Nut Lbs Whole or Ground *Grind
Hawaiian Choc. Macadamia Nut Lbs Whole or Ground *Grind
Kookiedoodle Lbs Whole or Ground *Grind
Gift Certificate                     $ Amount                        Gift Certificate         $ Amount
Total Gift Certificate(s)
Total Quantity Pounds Ordered: 
Total Cost: Lbs. x $9.95 
Coffee Shipping 4 Pounds or More within the Continental U.S.  Free
Shipping: 1-3 Pounds

$7.00
Ca Residents add 7.75% sales tax
Total:  
        Name:  	 ___________________________________
        Address:	 ___________________________________
                                ___________________________________
        Phone:        _________________________
        E-Mail:      __________________________
 
How will you be paying? ________________________________________
Card Number: __________________  Expiration Date: MM/YY ______________
Name Appearing on Card: ______________________________________
     Additional Message/Special Needs:
Please use this area to describe special needs, requests for more information, etc.)
___________________________________________________________________________________

34531 Golden Lantern, Dana Point, CA 92629    (949) 493-7773    Fax (949) 493-1730 
E-mail