Please add $4.00 for orders shipped west of the Mississippi river.

No shipping to Hawaii, Arizona, California, Texas, Louisiana, Alaska, nor Canada

Butrico Groves Order Form

6065 Magnolia Street ~ Mims, FL  32754

My Name is         Date:

My Address is         

City    State   Zip code        

Phone   Email      

Ship to Names Listed Below                      

Name           Oranges Grapefruit   Mixed

Address             1/4 Bushel $25   1/2 Bushel $40

City    State   Zip code         Full Bushel $60

Phone                                                           Amount

Gift Card to Read

When to ship (check One) if not indicated, will go with next shipment               Next Shipment      For Christmas

 

Name Oranges Grapefruit  Mixed

Address   1/4 Bushel $25   1/2 Bushel $40

City    State   Zip code         Full Bushel $60

Phone                                                           Amount

Gift Card to Read

Customer Signature:  
    Total:
mm/yy
*Verification code is on the back of card

When to ship (check One) if not indicated, will go with next shipment               Next Shipment     For Christmas