Electronically Submit Your Citrus Sale Reservation Form

Yes! Count On Us Using Florida Indian River Groves For Our Upcoming Citrus Fundraising Sale!

Complete the following form using the TAB key to move between fields. Please provide all requested information. When you have completed the form, please click on the SUBMIT button to send your request. If you make a mistake, simply resubmit the form.

Contact Information
Organization Name:
Main Contact:
Title:
Mailing Address:
City:
State:
Zip Code:
Daytime Phone Number:
      Extension:  
Evening Phone Number:
      Extension:  
Fax Number:
Cellular Number:
Email Address:
Organizational Website:

Alternate Contact Information
Name:
Title:
Daytime Phone Number:
      Extension:  
Evening Phone Number:
      Extension:  
Fax Number:
Cellular Number:
Email Address:

If Your Organization is Band, Chorus, or Athletic Booster Organization,
Please Provide the Following Information
Name of Director:
Director's Daytime
Phone Number:
      Extension:  
Director's Evening
Phone Number:
      Extension:  
Director's Email Address:

Please Ship Our Free Promotional Materials To...
Main Contact Listed Above
Alternate Contact Listed Above
The Address I've Provided Below:
Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:

Please Mail Our Invoice To...
Main Contact Listed Above
Alternate Contact Listed Above
The Address I've Provided Below:
Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:

Other Information
Approximate Number of Members Participating In Sale:
Please Ship Our Promotional Materials To Arrive By:

Please Select the Type of Promotional Materials You Plan to Use
5 Variety Product Flyer
4 Variety Product Flyer
3 Variety Product Flyer
2 Variety Product Flyer
Custom Printed Product Flyer
3 Part NCR Order Form
Money Collection Envelopes (Green and White)
Money Collection Envelopes (Citrus Image)
8½ x 11 Promotional Poster
14 x 20 Promotional Poster
24 x 36 Promotional Poster

Our Anticipated Delivery Period Is...
Prior To Thanksgiving
After Thanksgiving
Spring

Additional Comments or Special Instructions