Ship From
Name:
Address:
City, State, Zip:
AL
AR
AK
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Email:
Method of Payment
Visa
MasterCard
American Express
Discover
Check
Cash (bring into store)
Credit Card Number:
Expiration Date:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
2002
2003
2004
2005
2006
2007
2008
2009
2010
Signature:
_____________________________________
Ship To
Name:
Address:
City, State, Zip:
AL
AR
AK*
AZ
CA
CO
CT
DC
DE
FL
GA
HI*
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Business
Residence
Gift card:
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sure it doesn't scroll off.)
Ship To
Name:
Address:
City, State, Zip:
AL
AR
AK*
AZ
CA
CO
CT
DC
DE
FL
GA
HI*
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Business
Residence
Gift card:
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sure it doesn't scroll off.)
Order
Total
These prices
include sales tax, package, handling, hand-written gift card and shipping
via UPS Ground.
* Shipments to AK, HI, or P.O. Boxes will be sent USPS Priority Mail.
Additional charges apply; call
for details.
Thank
you for support of locally grown produce.
We appreciate your order!