Welcombe Community Shop Association Ltd

Holiday Grocery Box Order Form

Before filling in this form, please check with your holiday accommodation provider
that they subscribe to this scheme and would be willing to collect the pack and
leave it in your accommodation ready for your arrival.

Surname:	Initials: Title:
Address:
Postcode:
Telephone number:	(home) (daytime)
Email:
Holiday Provider
Arrival Date

Please indicate number of items required below

Items marked * are locally produced.*	Price £	Quantity Required
White Sliced Loaf	1.29
Brown Sliced Loaf	1.59
Full Cream Milk 1 pint	0.46
Full Cream Milk 1 litre	0.82
Semi Skimmed Milk 1 pint	0.46
Semi Skimmed Milk 1 litre	0.82
Semi Skimmed Milk 2 litre	1.50
Skimmed Milk 1 litre	0.82
Butter 250g **	1.25
Olive Oil Spread 250g	1.55
West Country Bacon approx 300g	3.95
Free Range Eggs box of 6	0.99
Farmhouse MatureCheddar approx 240g	2.00
Cornish Yarg approx 200g **	3.14
West Country Goats Cheese approx 150g **	2.44
Yeo Valley Natural Yogurt 500g **	1.36
Yeo Valley Fruit Yogurt 500g **	1.51
Steak & Ale Pie (or similar) 940g **	5.75
2 "Bob the Butcher" Beefburgers" approx 250g **	1.88
"Bob the Butcher" Pork Sausages approx 550g **	3.45
Apples approx 1kg	1.80
Potatoes approx 1kg	0.95
Green & Blacks 70% Dark Organic Chocolate 100g	2.09
Cottage Cakes Lemon Drizzle (or similar) 300g **	2.20
Kelloggs Cornflakes 250g	1.65
Kelloggs Variety Pack	2.49
Weetabix (12)	1.35
Fairtrade Muesli 500g	2.51
Granulated Sugar 500g	0.55
Orange Juice 1 litre	1.44
Apple Juice 1 litre	1.39
Ready Salted Potato Crisps 31.8g	0.35
Orange Squash 1 litre	1.19
Heinz Baked Beans 415g	0.79
Tinned Tomatoes 400g	0.69
Heinz Tomato Soup 400g	0.99
Baxters Carrot & Coriander Soup 415g	1.15
Heinz Tomato Ketchup 300ml	1.49
PG Tips Tea bags 40	1.29
Nescafe Instant Coffee 50g	1.55
Fairtrade Ground Coffee 227g	3.94
Golden Shred Marmalade 227g	0.95
Tiptree Strawberry Jam 340g	1.99
Forest Organic Honey 340g	2.97
Bourbon/Custard Cream Biscuits (as available)	0.69
Chocolate Hob Nobs	1.99
Welcombe Shop Cookies 200g	1.49
Buitoni Pasta Twists or equivalent	1.19
Long Grain Rice 500g	1.59
Olive Oil 250ml	2.09
Sunflower oil 1 litre	1.89
Washing up Liquid 500ml	1.05
Kitchen towels 2 rolls	1.00
Winalot dog food tin 400g or equivalent	0.79
Toilet Rolls 2 pack	1.09
Heavy Duty Rubbish sacks	1.77
OS Map Landranger 190 (Bude & Clovelly)	6.99
Shop Recommendation Red wine 750ml	4.99
Shop Recommendation White wine 750ml	4.99

Prices may vary but will not exceed those shown. Prices as at 29/7/11
If the cost of your order should be lower than the amount of your cheque, you will be reimbursed.

If you are ordering wine, please tick this box to confirm that you are over 18 years of age:

Please type the word "onions" in this box: (to prove that you are not a computer program).

to send your order.

You will receive a confirmation email telling you the value of the groceries you have ordered. Please send a cheque, made payable to "Welcombe Community Shop" for that amount to your accommodation provider when you send them the final payment for your holiday.

Thank you for supporting our village shop