| Name | ||
| Address | ||
| City | State | Zip |
| Phone (   ) | Email Address | |
| Name | ||
| Address | ||
| City | State | Zip |
| Quantity | Ship Now/ Later |
Description | Price | |
| SUBTOTAL | $ | |||
| SHIPPING |
. |
.. | ||
| TOTAL | $ | |||
|
SHIPPING RATES: $00.01 - $09.99 = $7.70 $10.00 - $19.99 = $8.25 $20.00 - $29.99 = $10.25 $30.00 - $39.99 = $15.00 $40.00 - ..UP.. = $18.00 |
Make Checks Payable To: Plantastik |