Print and fax or mail this form. See address/phone # at bottom. Ship to address (if different) Name: _______________________________ Name: __________________________ Address: ____________________________ Address: _______________________ City/State/Zip: _____________________ City/State/Zip: ________________ Phone #: ____________________________ Payment:___ Check Enclosed We accept Discover, Mastercard and Visa. ___ Credit Card # ________________________________ Exp. ________ CVC #_______ (3 digit # from back of card on signature panel) Please Note: *** $20 Minimum Order *** Item Size Price Quantity Extended ------------------------------------------------------------------------ Homemade Jam/Butters Apple Butter 10 oz. $3.25 ________ ________ Apricot 10 oz. $3.25 ________ ________ Blackberry 10 oz. $3.25 ________ ________ Seedless Blackberry 10 oz. $3.25 ________ ________ Sdls. Black Raspberry 10 oz. $3.75 ________ ________ Blueberry 10 oz. $3.40 ________ ________ Cherry 10 oz. $3.25 ________ ________ Hot Pepper 10 oz. $3.25 ________ ________ Orange Marmalade 10 oz. $3.25 ________ ________ Peach 10 oz. $3.25 ________ ________ Plum 10 oz. $3.25 ________ ________ Pumpkin Butter 9 oz. $3.25 ________ ________ Raspberry-Jalapeno 10 oz. $3.25 ________ ________ Red Raspberry 10 oz. $3.25 ________ ________ Seedless Red Raspberry 10 oz. $3.25 ________ ________ Strawberry 10 oz. $3.25 ________ ________ Strawberry Rhubarb 10 oz. $3.25 ________ ________ Apple Butter 19 oz. $4.25 ________ ________ No Sugar Apple Butter 19 oz. $4.25 ________ ________ Apricot 20 oz. $4.25 ________ ________ Blackberry 20 oz. $4.25 ________ ________ Seedless Blackberry 20 oz. $4.25 ________ ________ Sdls. Black Raspberry 20 oz. $4.75 ________ ________ Blueberry 20 oz. $4.50 ________ ________ Cherry 20 oz. $4.25 ________ ________ Elderberry 20 oz. $4.25 ________ ________ Hot Pepper 20 oz. $4.25 ________ ________ Orange Marmalade 20 oz. $4.25 ________ ________ Peach 20 oz. $4.25 ________ ________ Plum (Damson) 20 oz. $4.25 ________ ________ Pumpkin Butter 19 oz. $4.25 ________ ________ Raspberry-Jalapeno 20 oz. $4.25 ________ ________ Red Raspberry 20 oz. $4.25 ________ ________ Seedless Red Raspberry 20 oz. $4.25 ________ ________ Strawberry 20 oz. $4.25 ________ ________ Strawberry Rhubarb 20 oz. $4.25 ________ ________ 100% Fruit Spread Apricot 9 oz. $3.50 ________ ________ Seedless Blackberry 9 oz. $3.50 ________ ________ Blueberry 9 oz. $3.65 ________ ________ Cherry 9 oz. $3.50 ________ ________ Peach 9 oz. $3.50 ________ ________ Seedless Red Raspberry 9 oz. $3.50 ________ ________ Strawberry 9 oz. $3.50 ________ ________ Gift Boxes - Holds 3 jars Small - For 10 oz & Spreads $1.25 ________ ________ Large - For 20 oz, Salsas & BBQ $1.25 ________ ________ Chunky Salsas Mild 16 oz. $4.00 ________ ________ Medium 16 oz. $4.00 ________ ________ Hot 16 oz. $4.00 ________ ________ Specialty Salsa Mild Hot Bean 16 oz. $4.25 ________ ________ Medium Hot Bean 16 oz. $4.25 ________ ________ Mild Corn 16 oz. $4.25 ________ ________ Medium Corn 16 oz. $4.25 ________ ________ Mild Green 17 oz. $4.50 ________ ________ Medium Green 17 oz. $4.50 ________ ________ Fruit Salsas Mild Cherry 17 oz. $4.25 ________ ________ Medium Cherry 17 oz. $4.25 ________ ________ Mild Cranberry 17 oz. $4.25 ________ ________ Medium Cranberry 17 oz. $4.25 ________ ________ Mild Peach 17 oz. $4.25 ________ ________ Medium Peach 17 oz. $4.25 ________ ________ Mild Pineapple 17 oz. $4.25 ________ ________ Medium Pineapple 17 oz. $4.25 ________ ________ Mild Red Raspberry 17 oz. $4.25 ________ ________ Medium Red Raspberry 17 oz. $4.25 ________ ________ BBQ Sauce/Mustard Apple 19 oz. $4.00 ________ ________ Hickory Smoked 19 oz. $4.00 ________ ________ Honey 19 oz. $4.00 ________ ________ Hot & Spicy 19 oz. $4.00 ________ ________ Jalapeno Honey Mustard 19 oz. $4.00 ________ ________ Pickled Products Sweet Baby Beets 16 oz. $4.50 ________ ________ Mild Southern Chow Chow 16 oz. $4.50 ________ ________ Hot Southern Chow Chow 16 oz. $4.50 ________ ________ PA Dutch Chow Chow 16 oz. $4.50 ________ ________ Bread & Butter Squash 16 oz. $4.50 ________ ________ Sweet Onion Relish 16 oz. $4.50 ________ ________ Candied Sweet Dill Pickles 16 oz. $4.50 ________ ________ Candied Sweet Orange Pickles 16 oz. $4.50 ________ ________ Candied Mixed Sweet Pickles 16 oz. $4.50 ________ ________ Kosher Aged in Wood Dills 16 oz. $4.00 ________ ________ Bread & Butter 16 oz. $4.00 ________ ________ Hot Bread & Butter 16 oz. $4.00 ________ ________ Sweet-Mild Hungarian Pepper Relish 16 oz.$4.50 ________ ________ Dark Sweet Cherry Conc. 12 oz. $4.75 ________ ________ Dark Sweet Cherry Conc. 32 oz. $12.50 ________ ________ Sub-total ________ Shipping ________ Total ________ Shipping Rates Mix & Match Any 12 Jars & Receive Free Shipping (Add $7.50 to Western States) Mix & Match Any 24 Jars & Receive Free Shipping and 25¢/jars discount (Western States not included) All other orders add $4.95 shipping ($8.95 to Western States) ** Western States include WA, OR, CA, NV, AZ, UT & ID. ** $20 Minimum Order ** The Dutch Kettle Phone: (574) 546-4330 6375 Fir Rd. FAX TO: (574) 546-3550 Bremen, IN 46506