Banner flower farm dahlia mail order form

NAME OF VARIETY	QUANTITY	PRICE	TOTAL PRICE

PLEASE SEND CHECK OR
MONEY ORDER TO
JIM BANNER
BANNER FLOWER FARM
3532 104TH AVE.
ALLEGAN, MI. 49010

ALL ORDERS RECEIVED WILL BE CONFIRMED


					Banner Flower Farm 3532 104th Ave. Allegan, MI 49010 Website - bannerflowerfarm.com E-Mail Address - info@bannerflowerfarm.com Telephone Number - 269/744-8687

IF YOU HAVE ANY QUESTIONS,
PLEASE CONTACT US

                                                                                                           DATE: _________________
NAME: ____________________________________________________________
ADDRESS: __________________________________________________________
CITY: ________________________ STATE _____________ ZIP CODE: _________
PHONE: _____________________           Email: ____________________________

Will you accept substitutions?   Yes _______ No__________
(Equal or Greater Value)

2010 DAHLIA TUBER MAIL ORDER FORM

SPECIAL OFFER CODE #
SUBTOTAL
MICHIGAN RESIDENTS PLEASE ADD 6% SALES TAX
PLEASE ADD SHIPPING AND HANDLING 12.5% 1-5 tubers: $6 6-10 tubers: $8 11-15 tubers: $9 16-20 tubers: $11 21-25 tubers: $12 26-30 tubers: $13 over 30 tubers 14

TOTAL AMOUNT