PLEASE PRINT THIS ORDER FORM, COMPLETE, AND MAIL
(386) 454-3687
Name
Mailing Address
City
State
Zip
Home Phone
Day Phone
Email
Shipping Date
May We Subsitute?
Yes
No
Please list your choice of Bonus plants on a separate sheet.
METHOD OF PAYMENT
Check Enclosed
Money Order Enclosed
Charge My Credit Card
Visa
Mastercard -- Expiration
Card Number:
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Signature: ___________________________________________
QTY
CULTIVAR
PRICE
QTY
CULTIVAR
PRICE
1
.
.
.
.
12
.
.
.
.
2
.
.
.
.
13
.
.
.
.
3
.
.
.
.
14
.
.
.
.
4
.
.
.
.
15
.
.
.
.
5
.
.
.
.
16
.
.
.
.
6
.
.
.
.
17
.
.
.
.
7
.
.
.
.
18
.
.
.
.
8
.
.
.
.
19
.
.
.
.
9
.
.
.
.
20
.
.
.
.
10
.
.
.
.
21
.
.
.
.
11
.
.
.
..
.
.
.
.
22
.
.
.
.
.
.
.
.
(enclose instructions)
Gift Certificate Amount
.
Sub-Total
.
7% sales tax for FL residents
(
click here for shipping information
) Handling add
$10.00
Priority Mail add $.1 per plant
Express Mail add $10 plus $2 per plant
TOTAL
.
