New Day Dairy Beef Order Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Get exactly what you want for your freezer

Email *

Would you like to be added to our (mostly) monthly e-newsletter? Every time we send one out we pick a winner for $100 off a stay at the GuestBarn or $50 off on a beef order! *

Yes

Name (First, Last) *

Phone Number *

Address *

Beef Size *

Quarter (1/4) Beef

Half (1/2) Beef

3/4 Beef

Whole Beef

Month (and date if possible) of Pick-Up you are Reserving *

For Ground Beef, what size packages would you like to have it wrapped in?

1 lb packages

1 1/2 lb packages

2 lb packages

A Variety - please list below in "Other" - minimum 10lbs wrapped in any one style

Other:

Clear selection

For Ground Beef, would you like any specialty items? (specify below)

Yes

Clear selection

Please refer to our website for processing prices for the following options: Patties (1/3 or 1/4lb) wrapped in 4-20 patties a package (tell us # in a pkg), Beef Sticks (plain or with cheese), Summer Sausage (plain or with cheese). ** Minimum 10lb order of any specialty items. ** Please check specialty items below with # of lbs in Other Category. The remainder will be ground beef wrapped as specified above.

1/3lb patties (note total lbs & # in pkgs in Other)

1/4lb patties (note total lbs & # in pkgs in Other)

Beef Sticks - Plain (note total lbs in Other)

Beef Sticks - Cheese (note total lbs in Other)

Summer Sausage - Plain (note total lbs in Other)

Summer Sausage - Cheese (note total lbs in Other)

Other:

Do you need delivery of your beef? If yes, we will contact you for additional details. ** $25 fee within 15 miles of Clarksville. $1/miles after first 15 miles.

Yes

Clear selection

How will you being paying for your beef? * Do not submit payment information via this form. We will e-mail you an invoice with payment information when we receive this form. ** We do offer a payment plan option - see our website for details. *

Check in the mail

Via Credit Card online

Other:

By submitting this form with your name signed below you agree that you understand that: 1) your beef is reserved when we receive your deposit (we will wait 2-3 days to receive a check in the mail) 2) you will pay the locker processing fees directly 3) you are responsible for picking up your beef unless otherwise arranged. *

Thank you for supporting our local family farm and filling your freezer with beef!

If you have any questions please contact us via our website or call us at 319-278-4455.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms