Relay For Life Fall Fundraiser Order Form Relay For Life teams are selling cheese as part of our fundraising efforts supporting the American Cancer Society and its mission of saving lives through education, advocacy, research and services. The quality products we are selling come from the Wisconsin Dairy State Cheese Company, who promotes cheese products made in Wisconsin! Cheese is great gift or addition to any celebration. Boxes for mailing are available at bottom of the list. Thank you for your support in the fight against cancer! Total (1# unless noted) Price Sold At Qty Amount RELAY FOR LIFE OF: ______Merlot Cheese – Seasonal Feature $10.50 Colby $4.75 TEAM/Team Member: Co-Jack $5.00 ______Monterey Jack $4.75 PURCHASER NAME: Jalapeno $5..25 ______Green Olive Monterey Jack $5.75 Cranberry Jack – Seasonal Feature $6.00 PURCHASER PHONE Mild Cheddar $4.75 NUMBER: ______

Sharp Cheddar $6.00 EMAIL: ______Havarti $5.25 Havarti Dill $5.50 Gouda $6.00 Payment must be made at Smoked Gouda $6.50 the time the order is placed. Please make checks Provolone $6.75 payable to: Mozzarella (3% fat) $5.00 WI Dairy State Cheese Parmesan (Whole) $6.75 Swiss Lace (Low Fat) $7.00 Cheese delivery date is: Baby Swiss $6.00 November 4, in time for the holidays and gift giving. (sliced) $6.25 Pick up location and time Farmer’s Cheese $5.25 will be communicated to Blue Cheese $6.50 those participating. Buffalo Wing $5.25 TOTAL ITEMS Mushroom & Leek $6.00 ORDERED: ______Salami Cheese $5.00

Sharp Cheddar Spread (2#) $8.50 Green Crock with Sharp Cheddar Spread (12 oz.) $9.50 AMOUNT ENCLOSED: Blue Crock with Sharp Cheddar Spread (12 oz.) $9.50 ______Dairy Fudge Chocolate Cheese Spread (8 oz) $4.25 Aged Asiago Spread (8 oz) $3.75 DEADLINE FOR Crab Spread (7 oz) $4.50 ORDERS TO BE Pecan Cheddar Spread (8 oz.) $4.50 SUBMITTED IS Peppercorn Ranch Cream Cheese Spread (7oz) $4.00 OCTOBER 16! Swiss Almond Spread (8 oz.) $3.75 Port Wine Spread (8 oz.) $3.75 Group One/OC, NL Spicy Beer Spread (8 oz.) $3.75 Herb & Garlic Alacreme’ (8oz.) $3.75 Usinger Beef Summer Sausage (12 oz.) $6.50 *GIFT BOXES $1.50 Each Holds 4 Items Qty ___ Holds 6 Items Qty ___ Holds 8 Items Qty ___ Holds 10 Items Qty ___ TOTAL BOXES $______