DAHLIA LLAMA
Benita Jacobsen
P.O. Box 1033.
Lolo, MT  59847
(406) 273-2010
bjacobsen1@q.com

DATE: __________________

 

NAME: ________________________________________________________________________

 

ADDRESS: _____________________________________________________________________

 

CITY:____________________________STATE ______________ ZIP CODE: _____________

 

PHONE: _____________________________  Email: ___________________________________

 

SHIPPING DATE: __________________________

Quantity

NAME OF VARIETY

PRICE

TOTAL PRICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                                                                                             Sub Total:   $ __________.______

                                                                                    Shipping & Handling:   $ __ _____ $7. 00____

                                                                                                                                      Total:    $ ____ ______.____  _

 

Will you accept substitutions?  Yes _______ No__________