| Fax to: 609-924-8569 |
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| Name: ________________________ |
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Phone: ______________________ |
| *Cred Crd #: ___________________ |
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Expiration: _________CVV______ |
| Street Address: _________________ |
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Zip Code: _____________ (Req'd) |
| ______________________ (Req'd) |
| Preferred Ship Date____________________ |
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| Unless noted, all gift boxes can be shipped or picked up at the Farm Store |
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| Apple Box - 11 lbs |
$25.00 |
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| Medium Sampler Box - 8 lbs |
$25.00 |
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| Large Sampler Box - 10 lbs |
$45.00 |
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| Medium Taste of New Jersey - 7 lbs |
$30.00 |
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| Large Taste of New Jersey - 11 lbs |
$50.00 |
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| Farm Pantry Box - 7 lbs |
$25.00 |
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| Gallon of Cider - 10 lbs ** |
$12.00 |
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| Donuts (2 doz) - 4 lbs ** |
$16.00 |
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| Gingerbread House - 4 lbs *** |
$58.00 |
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| * We accept MasterCard, Visa, Discover |
| **Expedited Shipping recommended; only available for shipping |
| *** Available December only |
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| Shipping: |
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| Total: |
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| Ship to: |
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Message: |
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| ____________________________ |
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| ____________________________ |
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| ____________________________ |
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| Phone # _____________________ |
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