Blooming the Past in the Present

Please print and fill out this order form, then send check or money order enclosed with your order.
Sorry, we do not accept credit cards, much too modern.

Name________________________________________________________________________

Address for UPS delivery________________________________________________________

_____________________________________________________________________________

Phone______________________________________

Email_______________________________________

Requested ship date for plants (from 4/15 - 9/15)_________________

May we substitute if unavailable? Yes_______ No_______

Overpayments: Credited to account_______ or Refunded________

Qty.	Name	Price	$ Total

Shipping charges to each delivery address: up to $39.00: $8.50 $40.00 - $100.00: 18% of order total $101.00 and up: 15% of order total

Subtotal___________ Shipping___________ Subtotal plus shipping___________ Add 5% sales tax for shipment within WI___________ Total Enclosed___________

Heritage Flower Farm LLC
33725 Hwy L, Mukwonago WI 53149
262-662-0804
badelman@wi.rr.com
www.heritageflowerfarm.com