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Bagel Order -Form Fill
Section One
Q1
Bagel List
Quantity
Quantity
Quantity
Quantity
Q2
Name
First Name
Q3
Name
Last Name
Q4
Phone Number
Q5
Email
Q6
Date & Time You Want to Pick Up Your Order
Date
Q7
Date & Time You Want to Pick Up Your Order
Hour Minutes
Q8
Date & Time You Want to Pick Up Your Order
AM/PM Option
AM
PM
Q9
Additional Instructions/Comments
Q10
Payment Methods
Debit or Credit Card
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