APPENDIX N 

 FORM A 



PROPOSAL TO SUPPLY MILK 



TO 



THE AYLESBURY DAIRY COMPANY, LIMITED 



Full Christian and Surname of Proposer. Full Postal Address. Shortest 

 Telegraphic Address. Name of Telegraph Office and distance from same. 

 Railway Station from which Milk will be sent, and distance from Station. If 

 there is any other Railway Station within working distance, state name, and on 

 what line of Railway. Time of arrival in London of Trains by which the Milk 

 could be sent : — Week days — Morning, Evening ; Sundays — Morning, Evening. 

 Average number of Cows kept. About lowest Winter quantity, Imperial 

 Gallons. About highest Summer quantity, Imperial Gallons. Source of Water 

 Supply for Cooling and Washing purposes. Is Water from any other source 

 ever used in the Dairy ? Is there a boiler properly fixed and provided with an 

 ample supply of Water which is not used for household purposes? Is there a 

 refrigerator ; if not, is Proposer willing to fix one. Name and Address of the 

 Medical Officer of Health for the District. Price asked, delivered in London 

 (each month). 



Any other particulars : — 



Signed- 



Date- 



N.B. — The Aylesbury Dairy Company find Chums, and pay by cheque 

 every Friday for all Milk supplied up to the previous Saturday. 



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