DATE
ORDER # __________
Shipped
Name:___________________
Ship address if different
TEMP #
packed by
Address:_________________
Town/City ________________
State: ________________
Zip:
______ __________
Tel:
_________________
Fax:
_________________
email _________________
For US customers because we are a Canadian company credits
cards are charged in Canadian dollars and the company you deal with will
reconvert it
on your monthly statement. We use the exchange rate that
our bank uses when charged.
Will you accept a size sub?
similar color?
Preferred ship date: Spring Fall
Name of Plant(collection)
Quantity
Price
Total
picked packed
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
-If you would like to buy a Colby Wishing Star
PIN or KEYCHAIN pin please add $3.00USD
to the following line. See about
us section of the site
for info
_________
Please attach extra sheet if needed. Plant subtotal __________
Shipping __________
shipping $10.00 plus 8% of order
total USD ___________
For orders with 1 plant $8.00 for shipping
name (as on card)
Visa, Mastercard
______/ ______/ _______/ _______ exp date
I authorize Select Plus Int Nursery to charge this
to my credit card for this purchase only. X
For office use only USD$
x
Cdn exchange rate=
Canadian $