Gift Basket Order Form

Customer E-Mail

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E-Mail:*

Grove Fresh Indian River Fruit from our own Groves

1/4 bu. Indian River Fruit

2/5 bushel Indian River Fruit

1/2 bu. Indian River Fruit

3/4 bu. Indian River Fruit

Full bu. Indian River Fruit

3 Month Club Plan

Juice Oranges or Grapefruit

Sour or Seville Oranges:

Grapefruit

Help us get a NEW TRACTOR SPECIAL!

Grand Total:

Billing Information

First Name:*

Same name as on your card

Middle Initial:

Last Name:*

Address Line 1:*

Where your statement is mailed

Address Line 2:

Apt. or Suite No.

City:*

State:*

Zip Code:*

Phone:

Shipping Information

First Name:

Middle Initial:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

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