182 Bedford Highway
Halifax Nova Scotia Canada
B3M - 0A4

Ph: (902)-443-6093
Fx: (902)-443-3945
LaDolceVita@eastlink.ca

Acai Order form

Intersted in ordering some Acai Berry juice please fill out the form below and someone will contact you shortly

Fields in bold are required.

First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Contact email:
Contact Phone number:
How many bottles would you like
How Many Cases 4 to case
Special Instructions