Order Form

Clearview Dahlias

Dick and Danielle Parshall

20212 65^th Ave. SE

Snohomish, WA  98296

Telephone:  425-486-6163  Email:  parshalld@prodigy.net

Name: _________________________________________________________________

Address:________________________________________________________________

City, State, Zip :__________________________________________________________

Telephone: __________________________ Email:______________________________

Shipping Date: _______________________ weather permitting. Dahlias will be shipped between April 1 and April 15 unless you’ve requested an earlier date.

Quantity

Variety Name

Unit Cost

Total

                                                                             Sub-Total    ______________

                                                     WA  residents Tax:  8.8%    ______________

                                                                             Shipping      _______$6.00___

                                                                             Total Due     ______________