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Yes, I would like to order the Bashas Community Support Card!

name: ______________________________ Lmalls :________________


Chlld's name: __________________________
1eacher:________________
number of cards wanLed: ______aL $10 each
lor a LoLal amounL due of $ _________
Clrcle one
------l agree LhaL Lhe card(s) can be senL home wlLh my chlld ln hls/her
backpack.
------l would llke Lo make arrangemenLs Lo plck up Lhe card(s) myself.
lease puL Lhls order form ln an envelope marked 8ashas'" wlLh cash or
check (made ouL Lo Canyon vlew llC") for Lhe LoLal amounL due.

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