Requisition Supplies/Materials Form

Custom Order Form - Members ONLY
Pick-up Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year**Wednesday 4-6PM or Saturdays 10AM-3PM ONLY
Name

First NameLast Name
Pick Up Location
Orders must be placed by:
- MONDAY 5PM for Wednesday Pick up
- THURSDAY 5PM for Saturday Pick up
Orders will be fufilled as closely to requested per inventory/stock.

If there is an item you do not see listed, write in the comments and we will fulfil if avaliable.
Payment will be collected at time of pick up; cash or card accepted.

Vegetables

Rows	Quantity Requested	Quantity Received	Price
Lettuce Head (small)
Lettuce Head (large)
Iceburg Lettuce
Salad Mix
Spinach
Green Onion (scallions)
Cilantro
Parsley
Rosemary
Asparagus
Beets
Bok Choy
Broccoli
Brussel Sprouts
Cabbage
Carrots
Cauliflower
Celery
Corn
Cucumber
Eggplant
Escarole
Garlic
Green Beans
Kale
Swiss Char
Collards
Kolrabi
Mushrooms
Onion LG
Onion SM
Fresh Onion (Strawberry onion w/ greens)
Lunch Box peppers
Hot pepper
Bell Pepper (Green)
Bell Pepper (red)
Bell Pepper (yellow)
Baking Potato
Red Potatoes
Radish (red)
Radish (black)
Roma Tomatoes (basket)
Slicing Tomato
Spaghetti Squash
Yellow Squash
Zuchinni
Sweet Potato
Turnip

Please type in your request for vegetables that are not included in the list above

Fruits / Eggs / Misc

Custom Order Form - Members ONLY