Date:________________________
MY WILD IRIS ROWS
4919 Rincon Ave
Santa Rosa, CA 95409
(707) 537-7346
Order #______________________
(for office use only)
Ordered by:
Ship to: (if different)
Name: Name:
Street: Street:
City: City:
State/Zip Code: County:
State/Zip Code: County:
Phone:                                                          Email:

 Phone:
   Gift? Y N      Include Invoice? Y N

** May we SUBSTITUTE with equal or greater value for sold out varieties?     YES     NO
QTY Variety Price Each Total QTY Variety Price Each Total
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Total first column
  
Total this column
  
SHIPPING CHARGES BY STATE
ZONE 1 $9.00 plus add $.25 per rhizome AZ, CA, ID, MT, NV, OR, UT, WA, WY
ZONE 2 $9.00 plus add $.50 per rhizome AR, CO, KS, LA, MN, NE, NM, ND, OK, SD, TX
ZONE 3 $9.00 plus add $.75 per rhizome AK, AL, CT, DC, DE, FL, GA, IL, IN, IA, KY, ME, MD, MA, MI, MS, MO, NH, NJ, NY, NC, OH, PA, RI, SC, TN, VT, VA, WV, WI
 Total from first column
  
(Minimum Order: $15)   SUBTOTAL
  
Sales Tax 8.5%
  
Shipping/Handling Charges
  
TOTAL
  
Orders must be received by August 15, 2012