Fruit Order Form

Fruits Available (Dozen = 12)
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Oranges$5/dozen, $10/2-dozen
$5.00 Quantity
Item subtotal:$0.00

Total

$0.00
Name*
Full Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Pickup/Delivery*
Date For Pickup/Delivery*

MonthDayYear
Date
Time for Pickup/Delivery*
Address (Only for Delivery)

Home Address

Street Address Line 2

CityState

Zip Code
Comments
Your Total:*
All item Total:
Once you Submit your form, you will be automatically redirected to the Ekal Tree Campaign page for making donation.

Note: Make donation using same name you used to fill this form. Please don't make anonymous donations by not checking "Do not display my name on the campaign page" it cannot be tracked back to your order.

Click here to go to Donation Page
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