SAM’S CLUB FRESH SPECIAL ORDER FORM Order must be made in person at your local Sam’s Club – Order will not be placed online. Additional flavors and varieties may be available. Please check with your local club.

1. SIZE (Choose 1) 10” ROUND CAKE 1/2 SHEET CAKE FULL SHEET CAKE – 30 COUNT Serves 12-16 Serves 36-48 Serves 72-96

1/2 SHEET CAKE / CAKE COOKIE CAKE 5” Cake/ 10 Cupcakes

CUPCAKE COMBO Serves 30 Serves 36-48 Serves 14-16 Serves 64-76 (Not available for all items)

2a. CAKE FLAVOR (Choose 1) White or – (10” Round, ½ Sheet and Full Sheet Available) Marble – (Available in ½ Sheet and Full Sheet Only)

2b. CUPCAKE FLAVOR (Choose 1) White Chocolate White/Chocolate Mixed

3. (Choose Whipped Icing or But-R-Crème Icing)

WHIPPED ICING BUT–R–CRÈME

White Chocolate White Chocolate Border Color: Border Color: Flower Color: Flower Color: Balloon Color: Balloon Color:

Color Choices: Red, Orange, Yellow, Green, Pink, Light Blue, Dark Color Choices: Asparagus Green, Holiday Green, Pink Thread, Hot Blue, Lavender, Green Mist, Pink Petal, Spring Yellow Pink, Light Blue, Royal Blue, Purple, Red, Neon Orange, Amaryllis Yellow, Yellow, Bright Green, Coral, Teal

4. WRITING ON CAKE (Please print clearly)

5. DECORATION (Choose 1 from lists below) Every Day Celebrations Special Occasions Characters Seasonal Enter design name from Cake Book Enter design name from Cake Book Batman Fall Leaf Rings DESIGN NAME: ______DESIGN NAME: ______Cars – McQueen & Mater Pumpkin and Leaves Pop Top ______Disney Princess Dora the Explorer Frozen Hello Kitty Jurassic World My Little Pony Sesame Street Edible Decorations Spider Man Enter design name from Cake Book SpongeBob SquarePants DESIGN NAME: ______Super Mario ______Teenage Mutant Ninja Turtles Toy Story 3 Transformers

6. MEMBER INFORMATION (Please print clearly) Member Name: Pick Up Date:

Daytime Phone Number: Pick Up Time:

Evening Phone Number:

Order Taken By:

Order must be made in person at your local Sam’s Club – Order will not be placed online. Additional flavors and varieties may be available. Please check with your local club. August 2015