Order Form 
To place an order, you can automatically e-mail this order form by clicking the submit button at the end of the form. Or if you prefer, you can print the form, fill it out and fax it to us at (908) 789-4702, or call us at (908) 789-4700. Thank you for your interest in Culinary's produce.

NAME

BILLING ADDRESS

CITY, STATE ZIP    

DAY PHONE

Your Email Address  

Shipping Address: 

SHIPPING ADDRESS

CITY, STATE ZIP    

EVENING PHONE

 

Fill in your order Now

Product Quantity

Product Quantity

Product Quantity

Product Quantity

Product Quantity

Please give us your comments, questions, or suggestions below.

 

 

 

PAYMENT METHOD
(If you would prefer, you may leave this portion blank and we will call you when we receive your fax or email.)

American Express     MasterCard Visa   

Card Number

Expiration Date

If your Order is complete, please click the Submit button.  We will not ship your order until we speak to you about cost, availability and billing options.

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Culinary Harvest Fingerling Potatoes