Your Name:
Your Pickup Location:
Your Pickup Date:
Your Phone Number:
Your Email Address:
BEEF
Roast
Rolled Rump Roast
Delmonico (Ribeye)
T-Bone
Porterhouse
Sirloin Steak
Sirloin Tip Steak
Round Steak
Liver
Ground (~ 1 lb.)
Stew (~ 1 lb.)
Soup Bones
Other
Cut?
PORK
Chops (2 or more p/pkg)
Steak
Roast
Ribs (slab)
Ham
Bacon (~ 1 lb.)
Sausage (~ 1 lb.)
Ground (~ 1 lb.)
Other
Cut?
LAMB
Chops (2 or more p/pkg)
Steak
Leg
Ground (~ 1 lb.)
Stew (~ 1 lb.)
Other
Cut?
EMU
CHICKEN
(whole)
EGGS
(1 dozen)
OTHER
Type of meat
Cut?
Quantity
OTHER
Type of meat
Cut?
Quantity
Please Note:
When you have completed this form, please click on the SUBMIT button to send your Meat Request
to Old Pine Farm. After you have clicked on the SUBMIT button, you should print a copy of your
order for your records.
The RESET button can be used to clear all of the fields you have entered.
*Depending on the butcher, the cuts listed may not always be available!
Meat Request Form
