UMM Peanut Order Form

Today's Date
Number of UNSALTED cases to be ordered
Number of SALTED cases to be ordered
Shipping Information
Order is for (Name)
Street Address
Phone Number
Re-enter E-mail address*
Billing Information - Only enter if different from shipping information above.
Person to be billed
Billing Address
Billing Address (City, State, Zip)
Billing Phone Number
Billing E-mail address*
Re-enter Billing E-mail address*
If order is for service personnel, please complete the following.
Service Personnel Rank
Service Personnel Name
Unit Name/Designation
Unit Address
Is service person serving overseas?

If overseas, this person...

*If you do not receive an email confirming receipt of this order within two business days, please email us at or call the Church office at 910.326.4822. (We will email the Billing E-mail address if it is different from the shipping address.)