BIRCH BAY DAHLIAS
12027 - 62nd Ave. S.
Seattle, WA  98178
SBGSeattle@aol.com

DATE: __________________

NAME: ________________________________________________________________________

ADDRESS: _____________________________________________________________________

CITY:____________________________STATE ______________ ZIP CODE: _____________

PHONE: _____________________________  Email: ___________________________________

SHIPPING DATE: __________________________

Quantity

NAME OF VARIETY

PRICE

TOTAL PRICE

Shipping:            1 to 10 tubers $7.00                                    Sub Total:   $ __________.______

 11 to 20 tubers $10.00

 Over 20 tubers $15.00 Shipping & Handling: $ __________.______

We ship US Postal Priority Mail.

Washington orders add 8.6% sales tax.        Washington State Sales Tax:  $ __________.______

Make Checks Payable to: Sandy Boley                                      Total:    $ ___________._____

Will you accept substitutions?  Yes _______ No__________