Peach, Blueberry & Cherry Order Form 2007
Please return this form along with your deposit to:
Afton Apple Orchard, 9225 St. Croix Trail So., Hastings, MN 55033
Phone: 651-436-8385 Fax: 651-436-4634
| Name: | _____________________________________________ |
| Address: | _____________________________________________ |
| City, State, Zip: | _____________________________________________ |
| Phone #: | ( )_______________________________________ |
| Email: | _____________________________________________ |
| Name & Work Phone Numbers: | |
| Wife: | _____________________________________________ |
| Husband: | _____________________________________________ |
| Special Instructions: | |
| ______________________________________________________________ | |
| ______________________________________________________________ | |
| Quantity | Price* | Total Cost | ||
| Sweet Dark Cherries | ___________ | X | $36.00 | ___________________ |
| Ranier Cherries | ___________ | X | $36.00 | ___________________ |
| Tart Cherries | ___________ | X | $36.00 | ___________________ |
| Blueberries #1 (mid-July) | ___________ | X | $32.00 | ___________________ |
| Peaches 1/2 bushel box | ___________ | X | $32.00 | ___________________ |
| Peaches 1 bushel box | ___________ | X | $57.00 | ___________________ |
| Blueberries #2 (mid-August) | ___________ | X | $32.00 | ___________________ |
| Total Order Cost: | ___________________ | |||
| 50% Deposit required on order: | ___________________ | |||
| Balance Due: | ___________________ | |||
*Prices subject to up to 10% increase, due to transportation
| Visa: _______ | MasterCard: _______ | Discover: _______ |
| Credit Card Number: | _____________________________________________ |
| Last Three Numbers on Back of Card: | _____________________________________________ |
| Expiration Date: | _____________________________________________ |
| Name on Credit Card: | _____________________________________________ |