Summer Survey Form

Summer Survey Form

BOX SIZE
NAME: / $30
ADDRESS: / $35
TEL / E-MAIL: / $40
WEEKLY BASIC / WEEKLY / (F) OR (M) / NEVER / VEGETABLE / WEEKLY / SOMETIMES / NEVER
Potatoes (or) / Broccoli
Potatoes: Gourmet / Cauliflower
Onions / Beans
Carrots / Zucchini
Apples: Red / Cabbage
Green / Pumpkin
Bananas / Butternut
Tomatoes / Sweet Potato
Lettuce: Iceberg / Corn
Cos / Chinese Veg
Festival/Fancy / Snow Peas
Mixed salad leaves pkt. / English Spinach
FRUIT / WEEKLY / SOMETIMES / NEVER / SALAD / WEEKLY / SOMETIMES / NEVER
Peaches / Capsicum: Red
Nectarines / Green
Plums / Cherry Tomatoes
Strawberries / Avocado
Grapes / Cucumber
Watermelon / Mushrooms
Rock Melon / Spinach leaves pkt.
Pears / Celery
Kiwi Fruit / Red Onion
Oranges / Spring Onions
Mandarins
Pineapple
Mango / EGGS (Extra)
1 Doz Free Range / $6.00
½ Doz Free Range / $3.00

Each box size contains 14 varieties of produce each week

The quantity of produce differs in eachbox size

WEEKLY:

Please make sure you have marked at least 30 ticks or more in your ‘weekly’ columns

Please tick (√)the produce you would prefer to receive in your box every week.
If you would like 2 portions of anything (eg. Double quantity of apples or 2 avocado or a full cauliflower etc.) Please indicate with a double tick(√√) however, this will then result in less varieties.

FORTNIGHTLY (F) or MONTHLY (M) orSOMETIMES:

If not weekly, please indicate if you would like your Weekly Basics either (F) or (M)
If not weekly, please tick which Fruits, Vegetables and Salads you would like to receive sometimes.

NEVER: Please tick the produce that you do not ever want to receive in you box.