Name
*
First Name
Last Name
Business Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
How would you like to receive your order?
*
Please Select
Free Pickup at MidAm Mushrooms
Delivery (Shipping Costs will Apply)
Delivery Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tax Exempt Certificate
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We require a copy of this form only once to exempt you from sales tax. https://dam.assets.ohio.gov/image/upload/tax.ohio.gov/forms/fill-in/sales_and_use/exemption_certificates/ST_STEC_U_FI.pdf
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What date would you like to receive your order?
*
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Year
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Month
Day
4 digit year, 2 digit month, 2 digit day
Please note: Our fresh blocks require a two-week production time. Orders must be placed at least two weeks in advance of your desired delivery date to ensure availability and quality. Thank you for planning accordingly.
Recurring Order?
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One Time Order
Weekly
Every Other Week
Monthly
Farmer Blocks
*
Rows
Quantity Requested
Blue Oyster
Pink Oyster
White Oyster
Brown/Phoenix Oyster
King Trumpet
Lion's Mane
Chestnut
Pioppino
H. coralloides (Coral Tooth)
Reishi
Shiitake
Total Farmer Blocks
Delivery/Pickup Requests
If your address above is different than the address you would us to ship to, please enter that information here. For pickup orders, please specify a pickup time between 10am - 4pm on your chosen date.
Please type in your request for any products that are not included in the list above.
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