Grocery Card Fundraiser Order Form

Consider using Giant, Darrenkamps, and Weis Grocery Cards to pay for your groceries, gas, and prescriptions each month.
Cards are available in amounts of $25, $50, or $100.
5% of your purchases will be donated to the EBIC Youth Group.

Use the form below to place your order for grocery cards. Once submitted, you will be contacted for payment information.

* Name:

* Email address:

* Designate your support:
Bible Quizzing
Youth Missions Trip

DARRENKAMPS

Darrenkamps Gift Card Value:

Number of Darrenkamps cards requested at this value:

GIANT

Giant Gift Card Value:

Number of Giant gift cards requested at this value:

WEIS

Weis Gift Card Value:

Number of Weis gift cards requested at this value:

PICKUP OPTION
How would you like your card(s) delivered?

* Choose one:
Church mailbox
Wednesday night clubs 6-7 pm
Sunday morning 9:30-10 am