Gift Box Order Form
NAME ON CREDIT CARD:
  
*
PLEASE CONTACT ME BY:
  
Email Phone Fax
E-MAIL ADDRESS:
  
*
STREET:  
CITY:
  
* STATE" *
TELEPHONE NO.
  
*
FAX NO. (Optional)
  
    Interested in Shipping a Gift Box:
 

20 lb. Fresh Apple Gift Box - $45, includes shipping
(West Coast shipments add $5)
    40 lb. Fresh Apple Gift Box - $60, includes shipping
(West Coast shipments add $5)
    Bushel Box of Fresh Apples - $75, includes shipping
(West Coast shipments add $5)
    Other, See My Comments Below
COMMENTS (OTHER)
  
SHIP TO:    
NAME:  
STREET:  
CITY:
  

*

STATE:   *
ZIP:   *
Charge Card Info:  

Card Type:

Account-Card No.

Exp. Date

Fax This Form To: (828) 685-8350 or Mail A Check With The Form

To: Coston Farm, 742 Apple Valley Road, Hendersonville NC 28792