DRHS Shelter Blend Pre-Order Form

We’re excited to introduce the DRHS Shelter Blend, a special coffee created in partnership with Windmill Coffee Roasters. This smooth, well-balanced blend is available in both drip and whole bean form and was carefully selected for everyday enjoyment by coffee lovers.

With every 12 oz. bag purchased, a portion of the proceeds directly supports the Dubuque Regional Humane Society and helps us care for animals in need.

NOTE: coffee orders will be placed on the 1st and 15th of every month (or on the next business day).

Orders are typically available for pickup or shipping (for an additional fee) within 2 weeks of purchase. As that date approaches, you’ll receive an email with pickup details or your estimated delivery timeline.

Contact Information

Name

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Address (Required for Shipping)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Order Details & Credit/Debit Card Payment

DRHS Shelter Blend WHOLE BEAN (Pick-Up)$20.50

Quantity
Item subtotal:

DRHS Shelter Blend WHOLE BEAN (Shipped)$26.50

Quantity

DRHS Shelter Blend DRIP (Pick-Up)$20.50

Quantity

DRHS Shelter Blend DRIP (Shipped)$26.50

Quantity

Total $0.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

*