JOHNSON’S COUNTRY MARKET

37049 Johnson Road, Selbyville, Delaware 19975

(302) 436-FARM (3276) OR (302) 436-7171

FRUIT BASKET ORDER FORM

Name: ____________________________      Telephone: _________________________

Address: ________________________________________________________________

All order forms need a $10.00 deposit and must be received by December 20, 2008. Please send forms to the above address and make checks payable to Johnson’s Country Market. Fruit baskets will be available for pick up every Wed, Thurs, Fri, Sat, and Sun in Dec from 10 a.m.– 5 p.m. We will be open Christmas Eve 10 a.m. – 2 p.m., or by appointment.

BASKET SIZE  (Prices may vary based on availability of citrus fruit.)

_____ Sm. fruit basket (Price $15.00-$19.00) _____ Lg. fruit basket (Price $25.00-$30.00)

 FRUIT VARIETIES Please select what fruits you would like placed in your fruit basket.

_____ Apples (red or yellow)  _____ Naval Oranges  _____ Pink Grapefruit  _____ Pears

_____ Bananas

                                                                                    TOTAL PRICE $______________