Daughters of the Nile
98th Annual Supreme Session
FRUIT BASKET ORDER FORM
COMPLETE ONE FORM FOR EACH ORDER – CALL, MAIL OR E-MAIL ORDER
PHONE (402) 630-0050
P.Q. Marti Neely
EMAIL: [email protected] (Place DON in the subject line)
9811 Sprague Street
Omaha, Nebraska 68134-3712
Temple Name
No.
Temple City
Name
Title as of June 1, 2014
Address
City
State/Prov ince
Zip/Postal
Telephone (
)
Cell (
E-Mail Address
)
(For Receipt Only)
Circle the day you will pick up order
Friday,
May 30th
Saturday,
May 31st
Sunday,
June 1st
Monday,
June 2nd
Tuesday,
June 3rd
Wednesday,
June 4th
Thursday,
June 5th
Fruit Basket
Healthy Start Fruit Basket
Oranges, Bananas, Red and Green
Grapes, Apples (Approx 3.5 lbs fruit)
$25.00
Delightful Choice Fruit Basket
Oranges, Bananas, Red and Green
Grapes, Apples, Pears and Grapefruit
(approx 4.5 lbs fruit)
$35.00
Classic Fruit Basket
Red and Green Grapes, Bananas, Pears,
Apples, Kiwi, Grapefruit and Oranges
(approx 6 lbs fruit)
$45.00
Market Fruit Basket
Red and Green Grapes, Bananas, Pears,
Apples, Kiwi, Mango, Pineapple, and
Oranges. (approx 7 lbs fruit)
$55.00
Name of Basket from Price List
Price
Payment may be made by check, credit card (Visa/Master Card), or mail order (U.S. funds only)
CREDIT CARD TYPE
EXPIRATION DATE
NUMBER
NAME AS SHOWN ON CARD
3 DIGIT NUMBER
If you are interested in a candy and/or snack basket, contact PQ Marti Neely for further information.
Make a copy for your records.