Mailing Address                                   DATE:______/____/________
Name ___________________________________________________________________________
Address ________________________________________________________________________
City, State and ZIP  ___________________________________________________________
Shipping Address (if different)
Name ___________________________________________________________________________
Address ________________________________________________________________________
City, State and ZIP ____________________________________________________________
Phone:  DAY (_____) _____________  NIGHT: (_____) _____________
Email: ______________________________________ Needed to inform you when we ship.

--QTY-- |  ------DESCRIPTION OF ITEM------  |  ----PRICE----  |  ----TOTAL------ 
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___________________________________________Total from other side   _____________
MINIMUM ORDER $20.00  ............................     Subtotal    _____________
                                                       Ship/Hand   _____________
                                   VA residents add 5% Sales Tax   _____________
Please check shipping dates.                           TOTAL       _____________
My order requires ___ number of shipments.            
Multiple shipping dates require multiple shipping fees.

EAST OF THE MISSISSIPPI: $10.00 Per shipment       WEST OF THE MISSISSIPPI:  $12.00 Per shipment  
PLUS + 25 cents per BEARDED IRIS plant 
OR +50 cents per ALL OTHER plants.

If sold out: Substitute [___]  Refund [___]  Please list substitutes on back of this form.
Payment enclosed    check [___]  money order [___]   VISA [___]   MASTERCARD [___]

Card Number __________________________________  Expiration Date ____/______

Signature _____________________________________________
Thank you for your order.  - -  -   
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