Order Form

AZ Lemonade Stand Order Form

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Customer Info		32 oz Premium Glass Jars (12 pack case)		16 oz Plastic Active Bottles (24 pack case)		4 oz Spicy Candy Bar Cases (12 pack Case)		Extra Items / Notes		Logistics		Address

Wholesale Form
Account or Location Name * *
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Please add your store number if applicable
Account Type *
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New or existing account
Where did you hear of us? *
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Name
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Required Authorized User Last
Phone Number *
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Email *
N/A
Terms and Payment Info *
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What are the terms? What are the payment preferences?
Notes or Question
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Current Flavors
Our Flavors
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Case Quantities - Each case comes with 12, 32oz Glass Jars

	How Many Cases
Pineapple Lemonade "Maui" (Seasonal)
Original Lemonade
Prickly Pear Lemonade
Strawberry Lemonade
Mango Lemonade
Watermelon Lemonade (Seasonal)
Huckleberry Lemonade
Jamaica Tea (Seasonal)

Glass Jar Notes or Questions
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Any questions, or requests, or if the flavor you are looking for isn't listed above mention it here.

Current Flavors
Our Flavors
N/A
Case Quantities - Each case comes with 24, 16oz Plastic Active Bottles

How Many Cases

Plastic Active Bottle Original

Plastic Active Bottle Prickly Pear

Plastic Active Bottle Strawberry
Plastic Bottle Notes or Questions
N/A

Any questions, or requests, or if the flavor you are looking for isn't listed above mention it here.

Current Flavors
Our Flavors
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Case Quantities - Each case comes with 12, 4oz candy bags

	How Many Cases
Spicy Candy Bar - SPICY RINGS
Spicy Candy Bar - PICOSITO MIX
Spicy Candy Bar - SPICY LITTLES
Spicy Candy Bar - XPICY HEADS
Spicy Candy Bar - PICOSITO WATERMELON
Spicy Candy Bar - SPICY PATCH
Spicy Candy Bar - SPICY GUSH
Spicy Candy Bar - EL MANGUITO

Notes or Questions
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Any questions, or requests, or if the flavor you are looking for isn't listed above mention it here.

Any items that are not listed in the pages before. Ex: Food items from BLT Kitchens, Racks, Displays, Decals, Posters ETC.
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Pick Up or Delivery *
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Delivery Address
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Street Address Address Line 2 City State/Region/Province Postal / Zip Code
Preferred Delivery Time
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dd-MMM-yyyy HH:MM AM/PM
Date-Time for Pick Up!
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dd-MMM-yyyy HH:MM AM/PM

Pick Up times are between 8AM and 4PM Monday thru Friday
Verification Code *
Enter the text in the box below

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