Kahawa Coffee Order Form

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Please use this form to order Muleba Blend from the Kahawa Foundation

Email *

Your Name

Cost Center to be Charged (Please note for Orders to Basel a pCard is required) *

What would you like to order? *

12 oz Whole Bean ($10.95 each)

12 oz Ground ($10.95 each)

5 lb Whole Bean ($65.00 each)

Other:

Required

Quantity: *

What date do you need this order available for pick up or delivered? (Note: Please allow three weeks for orders over 50 and 4-6 weeks for orders over 500)

Local orders can be picked up on the Genentech Campus (B35 Brew Station) or shipped to another location. Please indicate how you would like to receive your order. (Note: shipping costs for delivery outside of GNE campus will be calculated and added to the order).

Pick up at B35 Brew station

Deliver to another location

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If you need the coffee delivered to another location please include the address below:

Send me a copy of my responses.

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