Gulf Coast Blueberries
Blueberry Order Form
Customer Information
Customer Name
*
First Name
Last Name
Phone Number
*
Email Address
*
example@example.com
Order Date
*
-
Month
-
Day
Year
Date
Bluberries ***Prices Subject to Change***
*
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Large Bag of Blueberries (5 Pounds)
5- Pounds of Blueberries ***For orders over 5 bags, please call to place order at 850-982-1683.***
$
25.00
Quantity
1
2
3
4
5
Small Bag of Blueberries (1.5 Pounds)
1.5- Pounds of Blueberries ***For orders over 5 bags, please call to place order at 850-982-1683.***
$
8.00
Quantity
1
2
3
4
5
***Cash payments preferred, All Prices Are Final***
Notes or Special Instructions
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