PLEASE PRINT THIS ORDER FORM, COMPLETE, AND MAIL
Name
Address
City
State
Zip
Phone
Email
UPS Directions
Shipping Date
May We Subsitute?
Yes
No
METHOD OF PAYMENT
Check 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
.
.
.
.
.
.
.
.
Gift Certificate Amount
.
Sub-Total
.
6% sales tax for FL residents
$15 for the first 10 plants ordered and $25 thereafter
Optional Next Day Air (call for quote)
.
TOTAL
.
