| Billing Information
Date:______________________ |
Shipping Information, if
different.
Buyer's
Name:_____________________________ |
VIDALIA SWEET ONIONS - Price includes shipping. |
||||
|---|---|---|---|---|
| ITEM # | DESCRIPTION | PRICE | QUANTITY | TOTAL |
| #1 | Jumbo Onion Box-10 lb. | $26.95 | . | . |
| #2 | Jumbo Onion Box-15 lb. | $34.95 | . | . |
| #3 | Jumbo Onion Box-25 lb. | $45.95 | . | . |
| #4 | Jumbo Onion Box-50 lb. | $79.95 | . | . |
| #5 | Medium Onion Box-10 lb. | $26.95 | . | . |
| #6 | Medium Onion Box-15 lb. | $34.95 | . | . |
| #7 | Medium Onion Box-25 lb. | $45.95 | . | . |
| #8 | Medium Onion Box-50 lb. | $79.95 | . | . |
| TOTAL = | . | . | ||
| ORDER SUMMARY | AMOUNT |
|---|---|
| Total Order: | . |
| . | |
| Sub Total: | . |
| GA residents add 6% sales tax: | . |
| TOTAL ENCLOSED OR CHARGED: | . |
| Check or MO:___ | Visa:___ | MasterCard:___ |
|---|
|
Account Number: |
. | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
|---|
Expiration Date:_________ Signature:_____________________(required. for credit card)
Special Instructions, or wording for a note sent to another recipient at another Shipping Address: