Order Form
Name
  
Address
  
City
  
State
  
Zip
  
Phone
  
E-Mail
  
May substitute if sold out? Yes No
Don't forget to list some second choices on order form
Desired Shipping Date: _______________
AHS Member? Yes No

Method Of Payment: Visa Master Card Check Enclosed

Card Number
___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___
Expiration Date

month ___ ___ year ___ ___ 3 digit CSV code _____
Signature _________________________________
Qty
Daylily Name
Unit
Price
Ext.
Price
Qty
Daylily Name
Unit
Price
Ext.
Price
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Sub Total
  
Shipping $15 for 1-5 plants, $20 for 6-10 plants, $27 for 11-20 plants, $36 for 21-30 plants and $48 for 31-50 plants
  
please list substitution and bonus plants on back of this form
TOTAL