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Order Form
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PLEASE PRINT THIS ORDER FORM, COMPLETE, AND MAIL
999 310th Street, Atalissa, Iowa 52720 | home: 563-946-3471
Name
Address
City
State
Zip
Phone
Email
Shipping Date
May We Subsitute?
Yes
No
METHOD OF PAYMENT
Check Enclosed
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Please make checks payable to: Walnut Hill Gardens
QTY
CULTIVAR
PRICE
QTY
CULTIVAR
PRICE
1
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12
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2
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13
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3
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14
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4
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15
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5
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16
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6
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17
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7
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18
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8
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19
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9
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20
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10
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21
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11
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..
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22
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Gift Certificate Amount
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Sub-Total
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see our shipping web page for pricing
Other Fees or Discounts
Iowa Sales Tax 7%
see our shipping web page for pricing
Postage
TOTAL
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