ORDER SHEET

Ayers Rainbow of Dahlias

336 Bremner Lane

Winston, OR 97496

(541) 580-8352 or (541) 580-5236
Email:
hlmayers@charter.net

 

ORDER DATE: _____________________

 

NAME:______________________________________________________________

 

ADDRESS: __________________________________________________________

 

CITY:_______________________STATE ___________ ZIP CODE: _______­_____

 

PHONE: ________________________  Email: ______________________________

 

REQUESTED SHIPPING DATE: __________________________

Ordering for 2010 is now closed.

Quantity

NAME OF VARIETY

Price

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                      Shipping:  1-9 tubers $8.00                   SUBTOTAL: __________._____

                                                   10-20 tubers $9.00

                                                 21 +  tubers $12.00                     SHIPPING: ___________._____

 

Check or money order must accompany your order.

Credit/Debit cards not accepted.                                             TOTAL: ____________.____


Thank You