Homestead Dahlias
P. O. Box 151
Yoncalla, OR 97499
Phone: (541) 849-2400
e-mail: the-ranch@centurytel.net
Website: http://www.homestead.grimloc.net
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DATE: ______________________
NAME: ______________________________________________________________________
ADDRESS:
___________________________________________________________________
CITY:__________________________STATE:_______________ZIPCODE:
________________
PHONE:
_____________________________ Email:
__________________________________
REQUESTED
SHIP DATE: _____________________
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Quantity
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NAME OF VARIETY
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UNIT PRICE
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TOTAL
PRICE
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$3.00
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$3.00
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$3.00
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$3.00
|
|
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$3.00
|
|
|
|
|
$3.00
|
|
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|
|
$3.00
|
|
|
|
|
$3.00
|
|
|
|
|
$3.00
|
|
|
|
|
$3.00
|
|
|
|
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$3.00
|
|
|
|
|
$3.00
|
|
|
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$3.00
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$3.00
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$3.00
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Postage: Sub
Total: $ __________.______
1 -10 Tubers $6.00
11-20 Tubers $7.50
Over 20 Tubers $9.00 Postage &
Handling: $ __________.______
Alternative
Choices (Substitutions): Total:
$ __________.______
_______________________ ___________________________
_______________________ ___________________________
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