Form Updated 11/3/20
Pickup at Farm only
Order Form
Pay by Check or Cash at Pickup
Date
Name
Please indicate Payment Method
Paying by Check
Phone No.
Paying by Cash
Email
How Many?
Leeks ($1.00 each)
How Many Heads?
Garlic Heads ($1.50 per head)
Hot Peppers (3 for $1.00)
How Many bunches of 3?
How many bars?
Goat Milk Soap (Large bar $5.00)
Goat Milk Soap (Small bar $4.00)
How many bars?
Arugula ($5.00 a bag)
How many bags?
How many?
Kohlrabi - Small ($1.00 each)
How many bunches?
Kale ($2.00 a bunch)
How many bunches?
Chard ($2.00 a bunch)
How many pounds?
Potatoes ($2.00 per pound)
TOTAL