Loaded Tea Set-Up Order Form
Loaded Tea Set-Up Order Form
Order your loaded tea set-ups to be delivered straight to your home! Set-ups will be mailed from Lufkin, Tx. after payment is received. This order form is only designed for ONE pack of 5 set-ups; if you would like more than one pack of 5 flavors, please fill out an additional order form. ***if you would like insurance added to your package please add an additional $6 and make a note in the comments section. ***please contact Pineywoods Nutrition on Facebook or text or call 936-676-8641 for pricing information. Payments can be sent via Cashapp- $hmgardner25 Venmo- @Heather-Gardner-01 PayPal- @hmgardner25
Name (for receipting purposes)
*
First Name
Last Name
Email (for receipting purposes)
*
example@example.com
Phone Number (for receipting purposes)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address* (required if shipping)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pick 5 flavors
Aloha (Lavender Lemon, Blue Raspberry)
Baby Fever (Blue Blast, Pink Lemonade)
Bad & Boujee (Banana, Strawberry Watermelon, Blue Blast)
Bam-Bam (Strawberry Watermelon, Melon)
Beth (Strawberry, Pineapple, Blue Blast)
Blackberry Pie (Blackberry, Melon, Peach)
Blackberry Spark (Blackberry, Cucumber)
Black Widow (Grape, Strawberry)
Blue Coconut (Blue Blast, Coconut)
Blue Gusher (Pomegranate, Raspberry, Blue Raspberry)
Blue Hawaiian (Lime, Blue Raspberry)
Bomb Pop (Blue Blast, Blue Raspberry, Strawberry)
Bumble B (Blue Raspberry, Pineapple)
Captain America (Strawberry Watermelon, Blue Raspberry)
Cherry Bomb Pop (Blue Blast, Blue Raspberry, Cherry)
Cherry Limeade(Cherry Limeade, Lime)
Cherry Pineapple (Cherry, Pineapple)
Cherry Pineapple Margarita (Pineapple, Margarita, Cherry)
Chik-Chik (Pineapple, Blue Blast, Blue Raspberry)
Cotton Candy (Cotton Candy, Blue Berry)
Cowboy (Peach, Pineapple, Strawberry)
Cranberry Pineapple (Cranberry, Pineapple)
Crazy Boss Lady (Raspberry, Coconut, Strawberry Watermelon)
Cucumber Splash (Lime, Cucumber)
Cucumber Watermelon (Strawberry Watermelon, Cucumber)
Grape Jolly Rancher (Grape)
Grinch (Blue Raspberry, Green Apple)
Golden Goose (Pineapple, Coconut, Orange)
Gummy Worm (Strawberry Watermelon)
Hulk (Pina Colada, Blue Raspberry)
Iron Man (Orange, Strawberry)
Jingle Juice (Green Apple, Cherry)
Leprechaun (Blue Raspberry, Green Apple)
Love Potion (Cherry, Watermelon, Pink Lemonade)
Mango Dragonfruit (Mango, Dragonfruit)
Mardi Gras (Pineapple, Blue Blast, Watermelon)
Mermaid (Coconut, Blue Raspberry)
Mexican Lollipop (Green Apple, Strawberry Watermelon; *With or without Tajin; please specify)
Oasis (Blue Raspberry, Pink Lemonade)
Ocean Wave (Orange, Blue Raspberry)
Orange Blast (Orange)
Pink Flamingo (Pomegranate, Pink Lemonade)
Peach (Peach)
Peach Crisp (Peach, Mango, Pina Colada)
Peach Mango (Peach, Mango)
Pink Christmas (Pink Lemonade)
Rip Wheeler (Mango, Pineapple, Pina Colada)
Santa’s Secret (Cherry)
Skittles (Strawberry, Grape)
Sour Green Apple (Green Apple)
Spring Breaker (Orange, Cherry, Watermelon)
Strawberry Jolly Rancher (Lime, Strawberry Watermelon)
Strawberry Colada (Strawberry Watermelon, Pina Colada)
Strawberry Margarita (Margarita, Strawberry Watermelon)
Strawberry Pineapple (Strawberry Watermelon, Pineapple)
Third Wheel (H3O, Fruit Punch, Blue Blast)
Tamarindo (Orange, Green Apple, Cucumber, Strawberry Watermelon)
Tango Mango (Mango)
Te Fiti (Cucumber, Blue Raspberry, Lime)
Tiger's Blood (Orange, Cherry)
Toxic Love (Blue Blast, Strawberry Watermelon, Prickly Pear)
Tropical Paradise (Tropical Fruit Punch, Pineapple)
Tropical Twist (Strawberry Watermelon, Pineapple, Coconut)
Under the Sea (Blue Blast, Blue Raspberry)
Watermelon Crawl (Watermelon, Green Apple)
Watermelon Thunder (Watermelon, Blue Blast)
Size
*
24 oz
32 oz
42oz
Special Instructions
**PLEASE make sure shipping address is correct. NO REFUNDS for putting incorrect shipping address. Please email hmgardner2006@gmail.com with any questions.
All prices include shipping.
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24 oz - Set up
5 packs of your favorite loaded teas, ask for pricing
$
40.00
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0.00
24 oz - Set up local pickup
5 packs of your favorite loaded teas, ask for pricing
$
30.00
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0.00
32 oz - Set up
5 packs of your favorite loaded teas, ask for pricing
$
57.00
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0.00
32 oz - Set up local pickup
5 packs of your favorite loaded teas, ask for pricing
$
47.00
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0.00
42oz Loaded Tea Setup
5 packs of your favorite loaded teas, ask for pricing
$
57.00
Quantity
1
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10
42oz loaded Tea Setup local pickup
5 packs of your favorite loaded teas, ask for pricing
$
67.00
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10
Payment Methods
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