ORDER FORM
Name and address
___________________________________
___________________________________
___________________________________ phone# ___________________
ITEMS ORDERED
STK# NAME QUANTITY
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
___________ ____________________________________ _______
PLANT TOTAL ____________
PACKING $5.00
SHIPPING XXXXXXX
TOTAL (Make checks out to Coenosium Gardens) _____________
Shipping will be billed at cost at time of shipment.