Spring Order Form

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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

Additions 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.)

Red Grapefruit

Temple Oranges

Honeybell Tangelos

Valencia Oranges

White Grapefruit

Mixed Box

Gift Box

Trio Pack

1 Bu. Apples

Pineapples

5 lb Valencia Bag

5 lb Grft. Bag

Delivery Location:

Delivery Address:

Address1:

Address2:

Address3:

City:

State:

Postal Code:

Phone:

Local Contact:

Empty Mesh Bags

Variety

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 to have a copy of what we receive from you.