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- Gift Basket Order Form
Gift Basket Order Form
Use for basket orders only for local delivery or pickup at Farm Store
| Fax to: 609-924-8569 | ||
| Name: _________________________ | Phone: _______________________ | |
| *CC #: __________________________ | Expiration: _________ CVV_______ | |
| Street Address#:______________________ (Req'd) | Zip Code: _______________ (Req'd) | |
| * we accept MasterCard, Visa, Discover - Delivery fee $10 for Lawrenceville and Princeton area. | ||
| Basket Choices | Store Pick Up Date | Delivery Date |
| $25 Farm Basket | _________ | ________ |
| $35 Farm Basket | _________ | _________ |
| $45 Farm Basket | _________ | _________ |
| $75 Farm Basket | _________ | _________ |
| $100 Farm Basket | _________ | _________ |
| Taste of New Jersey $30 | _________ | _________ |
| Taste of New Jersey $35 | _________ | _________ |
| Taste of New Jersey $50 | _________ | _________ |
| Taste of New Jersey $65 | _________ | _________ |
| Custom Basket $ ____ value-$200/max | _________ | _________ |
|
Subtotal:
|
_____________ | |
| Delivery fee: | $10 | |
| Total: | _____________ | |
| Special Requests:_________________________________________________ | ||
| Deliver to: | Gift Basket Message: | |
| _______________________________ | _______________________________ | |
| _______________________________ | _______________________________ | |
| _______________________________ | _______________________________ | |
| Phone#:_________________________ | _______________________________ | |