ORDER FORM
Organic Nutritional Energy Cooperative, Inc.
215.356.1365 text /call 215.424.8072
Premium Certified
ORGANIC
Fruits, Veggies &
Staples for Home & Cooking
Food Stamps, Check, Credit, & Debit Accepted
Pre Paid Average Value Deposit Required
$5 cash Delivery @ Driver’s Discretion
PRICING TIERS
Inquire about your Pre~paid Membership levels. Price adjustments will be made at the end of
the receipt as follows:
~WALK IN extra premium added
~WE PACK premium added
~U SHOP w requests set aside. Base pricing
~U WORK 4 hours over the month discount taken
Get FREE CERTIFIED ORGANIC PRODUCE equal in value to the average price of the food boxes of the (minimum) 4 new members' you bring in over that distribution cycle. Requests and Confirmations must be rec’d by the preceding Friday, Orders not collected prior to Tues 7pm subject to forfeit. No refunds.
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PRODUCE ORDER FORM
Distribution Dates:
Name: Feeding
Address, Apt #, City, State, Zip:
Phones, Text, Email:
Alternate Delivery Instructions:
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Circle all (PREFERRED) and Cross out all that are to be AVOIDED
DIET ~ Soul Food, Low Glycemic, Raw, Mediterranean, Seeded Fruits, Juicing, Baking, Preserving, Tropical, Asian, Local, Allergy, Salad
ROOTS ~ Potatos, Sweet Potatoes/Yams, Radish, Turnips, Rutabagas, Onions, Garlic, Radishes, Sunchokes, Ginger, Carrots, Turnips, Beets, Yacon, Shallots, Leeks
LEAVES ~ Lettuce, Spring, Mix Asian Mix, Spinach, Kales, Cabbages, Collards, WheatGrass, Bok Choi, Chard, Mustard,
VEGGIES ~ Broccoli, Cauliflower, Cabbage, Okra, Peas, Asparagus, Celery, Beans, Winter Squash, Summer Squash, Cucumbers, Artichokes, Eggplant, Peppers,
FRUITS ~ Tomatoes, Bananas, Apples, Pears, Seeded Grapes, Peach, Plum, Apricot, Pluot, Papaya, Pomegranate, Persimmon, Mango, Kiwi, Fig, Date, Oranges, Grapefruits, Lemons, Limes, Tangerines, Kumquat, Seeded Melons, Blueberries, Strawberries, Black Berries
OTHER ~ Mushrooms, Herbs, Sprouts, Peanuts
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ONE Coop TRIM WASTE U
Live Long & Prosper
Detox Grocery Box
$100 Deposit
Name:
Phones:
Circle all that (apply). Cross out all to be avoided:
FOOD PREP STYLE:
Take-Out, Fast Food, Soul Food, Salad, Vegan, Vegetarian, Raw, Live, Mediterranean, West African, North African, Caribbean, Chinese, Indian, Tropical, Local, Native American, European, Seasonal, Baking
TRIM WASTE U GOALS:
HEALTH CONCERNS: Fungus/Parasites, Cancer, Diabetes, Viruses, Hypertension, Mental/Emotional Function, Cholesterol, Heart Function, Allergies, Asthma, Skin, Weight, Bones, Auto-Immune, Other_______________
Be Specific:
Allergies:
Medications & Treatments Taking :
Supplements Taking:
Bowel Frequency & Consistency:
Blood type:
Favorite Weaknesses:
Salty, Crunchy, Oily, Sweet, Starchy…
Chips, Popcorn, Fried Chicken, French Fries, Cakes, Breads, Sodas, Butter, Eggs, Ice Cream, etc…
Organic Nutritional Energy Cooperative, Inc. Normal Shopping List
Smoothies:
Supplements:
Breakfast:
Dairy:
Beverages:
Snacks:
Lunch:
Beans:
Nuts:
Seeds:
Grains: Corn, Rice & Wheat Products ie. Flesh:
Sauces:
Spices:
Condiments:
Oils/Vinegars:
Seasonings:
Flavors:
Baking:
Desserts:
