3701 Highway EE ·
Owensville, MO 65066
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Name:
________________________________ Phone:
_________________E-mail: ________ Shipping
Address: Street:
_______________________Apt______ City:
_______________State_____ZIP_______ Note:
If billing address is different than shipping address, please add to back of
form. |
Payment
Method:
Check Enclosed (___)
MasterCard (___) Visa (___) Discover (___) Card
#________________________________ Exp.
Date___________ C.V.V #____________ Signature______________________________ |
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Use back of form for UPS
delivery instructions (rural residents & P.O. Box holders) |
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Qty. |
Name of Variety |
Price Each |
Total Price |
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Use back of order form for
additional space. TOTAL from reverse
side |
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May we substitute if sold
out? Yes (___) |
TOTAL (no minimum order) |
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No (___) |
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Substitution/Daylily Bonus
List: |
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MO residents add 5.6%
sales tax |
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UPS Ground ($9.50 for orders of
$20 or less, $13.00 for orders of $20.01 to $75, $17.50 for orders over $75.01) |
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Priority Mail ($12.00 + $1 per plant) |
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Desired shipping date (weather permitting):
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GRAND TOTAL
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