COWLITZ RIVER DAHLIAS

100 Chapman Rd.

Castle Rock, WA 98611   360-274-8292  e-mail:  teresa@dahliasuppliers.com

Date ___________________________________

Name_________________________________________________________________________

Address ______________________________________________________________________

Phone: _______________________________E-mail:__________________________________

 

Quantity

Variety

Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you run out of room, use back of form – total from back side

 

Subtotal

 

Add shipping – 1-8 tubers $5.00, 8-15 $6.00, 50 cents for each additional tuber (No charge if picking up.  You will be notified when they are ready)

 

Washington residents add 7.5% sales tax

 

Total enclosed with order

 

SUBSTITUTION:  May we substitute an equal or better variety if sold out?  Yes____No___

List choices for substitutions on back.