Blue Freedom Farm Markets, Inc.
      Your Fundraising & Gift Specialty Experts
                      

Fundraiser Confirmation - 2004-2005 School Year

  School and/or Organization: ________________________________________________________________

  City: ____________________________________________________ State: _________  Zip:______________

  School Phone: (___)_______________Ext. ______ Home Phone: (___)_______________

  Advisor Name: _____________________ ______   E-Mail: __________@__________________________

  *Blue Freedom Farm Markets, Inc. is getting ready to order brochures and packaging materials for
   the 2004-05 Fundraising Programs!  Please fill out the information below to assist us in providing you
   with brochures and your desired start and delivery dates. 

   Selling: (circle one)          FRUIT            FRUIT/CHEESE AND SAUSAGE                 SNACK STICKS 

   # of Students Selling: ________________  # of Brochures Needed:____________ 

  Suggested Retail*: (circle one)                      YES                      NO
  *If changing prices, please attach a copy of price changes on a separate sheet.
   

  Start Date: __________________________    

  Delivery Date: _______________________  Time: ________________________

  This confirms that all information and dates are correct and that delivery is expected on the dates
   listed  above unless notified within 7 days prior to delivery!

  Authorized Sponsor’s Signature: __________________________________________Date: _____________ 
  Representative’s Signature: ______________________________________________ Date: _____________

Master Tally Fruit Sale   Master Tally Fruit, Cheese & Sausage  Home      

Blue Freedom Farm Markets, Inc. 1-800-626-7582
1829 N. Locust Street - Sterling, IL - 61081
blue@bluefreedom.com
Sterling, IL     Johnstown, NY     Chippewa Lake, OH     Plant City, FL