Riversweet Citrus Fall Fund Raising Order Entry Form

Press TAB to move from field to field. Pressing ENTER will SUBMIT the form!

If you make a mistake just hit the BACK button and submit the form again

Your Organization's Name:

School Name (if applicable):

Your Name:

Day Phone Number:

Evening Phone Number:

Fax Number:

e-mail address:

Requested Delivery Date:

Requested Delivery Time:

This order is:

This order:

Numbers listed below are:

Our Original Order

Does not require wooden pallets

New Totals

A Change Order

Must ship on wooden pallets

Just changes to our order

With respect to sales tax:

Regarding transportation:

Numbers listed below are:

Do not charge us tax

Let Riversweet supply the truck

Our Final Numbers

Charge us sales tax

We will provide our own truck

Tentative Numbers

Large Box

Small Box

(4/5Bu.)

(2/5Bu.)

PLEASE REMEMBER!

Red Grapefruit

Use the TAB key to move from field

Navel Oranges

to field. If you accidentally hit the ENTER

Orlando Tangelos

key and submit the form, merely hit the

Juice Oranges

BACK button on your browser to save

Mixed Box

your data-then resubmit the form.

Trio Pack (RED-NAV-APPLE)

Trio Pack (PEAR-NAV-APPLE)

Again, let us thank you for having chosen

Apples

Riversweet Citrus.

Gift Box

Holiday Pack (PEARS-APPLES)

Pears

Pineapples

5 lb Navel Bagmaster

Each Bagmaster contains 8 bags!

5 lb Grft. Bagmaster

White Grapefruit

Delivery Location:

Delivery Address:

Address1

Address2

Address3:

City:

State:

Postal Code:

Phone:

Local Contact

Empty Mesh Bags

Size

Quantity

5lb.

8lb.

1/4 bu.

1/2 bu.

1 bu.

Please enter any special instructions or anything that you feel we should be aware of in the box below.

Please note that you can print this form out for your records before you click the submit button. You can also print out the page that follows.