Riversweet Citrus Sales - Beverage Collection Order Form

Beverage Order Form

If you are coordinating your Beverage Collection Products to arrive at the same time as your fruit order, please see to it that you arrange to have your Beverage Products arrive at least two days before your fruit. This will take into account that UPS deliveries take an extra day or two during the busy holiday season.

General Information:

Your Organization's Name:

School Name (if applicable):

Your Name:

Day Phone: Evening Phone:

e-mail address: Fax Number:

Requested Del. Date:

Information About Your Order:

This order is:

Our Original Order
A Change to our Original Order

Numbers Listed Below Represent:

New Totals
Just Changes to Our Original Order

With Respect to Sales Tax:

DO NOT Charge us Sale Tax
CHARGE US SALES TAX

Numbers Listed Below Are:

Our Final Numbers
Tentative Numbers

Your Order:

1. DC03-French Vanilla................................................

2. DC04-Hazelnut Creme:............................................

3. DC11 Breakfast Blend.............................................

4. DC23 Coffee Sampler..............................................

5. DC24 Jamaican Me Crazy......................................

6. DC26 Donut Shop......................................................

7. DC27 Donut Shop Decaffinated.............................

8. DC28 French Roast..................................................

9. DC29 Vanilla Hazelnut.............................................

10. WA01 A Wicked Good Morning..........................

11. WA02 Wicked Delicious Donut Shop.. ............

12. WA03 Wickedly Dark...........................................

13. WA04 Wicked Couple Vanilla & Hazelnut........

14. WA05 Wickedly Carmelized................................

15. WA06 Wicked Chocolate Brownie Toffee........

DELIVERY LOCATION FOR BEVERAGES:

Deliver Beverages To:

Delivery Address:

Address 1:

Address 2:

Address 3:

City: State: Zip Code:

Phone:

Name of Local Contact:

Special Instructions