2010 ORDER FORM

Customer Name	____________________________________________________________________________________
Address	____________________________________________________________________________________
City	_________________________________________________ State ________ Zip ___________
Telephone No.	_________________________________________________ email ___________________________

(Please provide telephone/email so we may contact you if there is a question regarding your order.)

Ship To	(if different than above)
Name	_____________________________________________________________________________________________
Address	_____________________________________________________________________________________________
City	___________________________________________________________ State ________ Zip __________

Quantity	Item	Price

Total Price

Packing & Shipping
Total # of Bulbs/Plants       Total P&S Cost
   1 -10                                       $ 9.50
11-15                                       $12.00
16-20                                       $13.50
21-25                                       $15.00
> 25           $15 plus 0.50 each additional

Sub-total
     MA 6.25% Sales Tax (MA addresses only)
      Packing & Shipping (see table at left)
      Total Enclosed

MAKE ALL CHECKS PAYABLE TO: David Burdick

                                             Preferred Substitutions/Special Requests
Do Not
Substitute _______
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