Product Order Form Home » Berries & Veggies » Product Order Form Place an Order613 833-2417PROULX@PROULXBERRYFARM.COM Business: Telephone: Email: Product Information Item #1 Product description: (e.g. maple syrup, strawberries, pumpkins, sweet corn, rhubarb) Product size (if applicable): (e.g. small/large, basket/bottle, 500ml, 1lt, 4lt) Quantity Product Information Item#2(if applicable): Product description: (e.g. maple syrup, strawberries, pumpkins, sweet corn, rhubarb) Product size: (e.g. small/large, basket/bottle, 500ml, 1lt, 4lt) Quantity Product Information Item#3(if applicable): Product description: (e.g. maple syrup, strawberries, pumpkins, sweet corn, rhubarb) Product size: (e.g. small/large, basket/bottle, 500ml, 1lt, 4lt) Quantity Pickup / Delivery Details: Date order required: Time required: 2nd optional date required: Time required: Distribution Location: The farmSugarbush or Farm Stands: CFMBFMOrléans MarketTrim St-Joseph If delivery, address: (extra charge may apply) Contact person on location: Telephone on location: Payment Method:CashCheque (no personal cheques accepted)interacE-transfer to:proulx@proulxberryfarm.comVISA / MC (With a 3% transaction fee) NOTE 1 : With a 3% transaction fee, VISA / MC are accepted NOTE 2: An agreement/invoice will be sent on approved orders only The agreement/invoice is to be sent by:EmailNot Required Deposit: A 50% deposit may be required at time of reservation. Comments or additional information: Proulx Maple & Berry Farm 1865 O'Toole Rd. Cumberland (Ottawa), ON K4C 1N2 Tel: 613-833-2417 Email: proulx@proulxberryfarm.com