FRUIT BASKET ORDER FORM

Please provide the following contact information:

First name	Last name
Street address
City
State/Province	Zip/Postal code
Work Phone	Home Phone
E-mail

Please provide the following ordering information:

For method of payment other than Credit Card please contact Cristi or Kayla at (225) 357-1448.

	BILLING
Credit card	select form of payment VISA MasterCard Discover
Cardholder name
Card number
Expiration date

Basket to be picked up at:

select pick up location 7201 Winbourne Ave. 5383 Jones Creek Road 3646 Drusilla Lane

Please provide the following ordering information for each Gift Basket to be shipped or picked up.

0 1 2 3 4 5 select item from list # 1 Deluxe Fruit Basket TubType 1/2 Peck # 2 Deluxe Fruit Basket Tub Type - Full Peck # 3 Festive Type Fruit Basket 22 lbs. # 4 Festive Type Fruit Basket with 3 lb. Boneless Ham 25 lbs. # 6 Honey Glazed Ham in Gift Basket 5-7 lbs. # 6A Honey Glazed Ham in Gift Basket 10-14 lbs. # 7 Hickory Smoked Turkey in Gift Basket # 8 Fruit Basket Mexican Style 40 lbs. # 9 Mex Style Fruit Basket with Smoked Turkey 50 lbs. # 9A Mex Style Fruit Basket with Boneless Baked Ham # 10 Louisiana Premium Navel Oranges 20 lb. Box # 11 Louisiana Premium Navel Oranges 40 lb Box # 12 Strawbetter Berry Cake # SP 1 Special Fruit Basket 75 lbs. #SP11 Special Fruit Basket 100 lbs. # SP111 Special Fruit Basket 125 lbs. #LA10 Louisiana Products Basket #LA30 Louisiana Products Basket #LA50 Louisiana Products Basket

Message on card to read:

0 1 2 3 4 5 select item from list # 1 Deluxe Fruit Basket TubType 1/2 Peck # 2 Deluxe Fruit Basket Tub Type - Full Peck # 3 Festive Type Fruit Basket 22 lbs. # 4 Festive Type Fruit Basket with 3 lb. Boneless Ham 25 lbs. # 6 Honey Glazed Ham in Gift Basket 5-7 lbs. # 6A Honey Glazed Ham in Gift Basket 10-14 lbs. # 7 Hickory Smoked Turkey in Gift Basket # 8 Fruit Basket Mexican Style 40 lbs. # 9 Mex Style Fruit Basket with Smoked Turkey 50 lbs. # 9A Mex Style Fruit Basket with Boneless Baked Ham # 10 Louisiana Premium Navel Oranges 20 lb. Box # 11 Louisiana Premium Navel Oranges 40 lb Box # 12 Strawbetter Berry Cake # SP 1 Special Fruit Basket 75 lbs. #SP11 Special Fruit Basket 100 lbs. # SP111 Special Fruit Basket 125 lbs. #LA10 Louisiana Products Basket #LA30 Louisiana Products Basket #LA50 Louisiana Products Basket

Message on card to read:

0 1 2 3 4 5 select item from list # 1 Deluxe Fruit Basket TubType 1/2 Peck # 2 Deluxe Fruit Basket Tub Type - Full Peck # 3 Festive Type Fruit Basket 22 lbs. # 4 Festive Type Fruit Basket with 3 lb. Boneless Ham 25 lbs. # 6 Honey Glazed Ham in Gift Basket 5-7 lbs. # 6A Honey Glazed Ham in Gift Basket 10-14 lbs. # 7 Hickory Smoked Turkey in Gift Basket # 8 Fruit Basket Mexican Style 40 lbs. # 9 Mex Style Fruit Basket with Smoked Turkey 50 lbs. # 9A Mex Style Fruit Basket with Boneless Baked Ham # 10 Louisiana Premium Navel Oranges 20 lb. Box # 11 Louisiana Premium Navel Oranges 40 lb Box # 12 Strawbetter Berry Cake # SP 1 Special Fruit Basket 75 lbs. #SP11 Special Fruit Basket 100 lbs. # SP111 Special Fruit Basket 125 lbs. #LA10 Louisiana Products Basket #LA30 Louisiana Products Basket #LA50 Louisiana Products Basket

Message on card to read:

• If you do not receive confirmation by email with-in 24 hours, please call Cristi  at (225) 357-1448.
• Thank you for your order.