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Name :
Street :
Neighborhood :
Zipcode:
Phone:
Email:
Type of box (choose 1 now, we'll bill you later):
Farmer's Box ($39)
Farmer's Jr box ($29)
Delivery Instructions (if your not home during the day, we would
like a safe, sheltered location to leave your box. Please enter this along with any other special instructions):
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Fresh Organic Produce Home Delivery Service