Produce Order
Date ordered *
MM
/
DD
/
YYYY
Personal Information
Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
Due to circumstances beyond our control, we may not be able to fulfill you order, in part, or in total. We will try our best to notify you if there is a change or problem *
Do I have permission to email or text you? *
Yes
No
Email
Text
Special instruction or questions
Your answer
NC
Tomatoes $2.25 LB. (FL, GA, or NC) + tax
Captionless Image
1LB
2LB
3LB
4LB
5LB
X1
X2
Heirloom Tomatoes $3.00 lb
25# Box (will Text Price)
NC
Squash $1.75 LB plus tax
Captionless Image
1LB
2LB
3LB
4LB
5LB
X1
X2
NC
Zucchini $1.75 LB Plus tax
Captionless Image
1LB
2LB
3LB
4LB
5LB
X1
X2
X3
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy