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Date_____________
Week you would like to pickup your plants. _____________
Name_____________________________________________________ Address_______________________________________ Shipping address ___________________________________ City, State & ZIP ____________________________________________Hardiness zone_____ Phone ________________________________ E-mail _____________________________________________
Please advise if SIZE substitutes are not acceptable. .
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Total Plant Cost: | ||||||||||
Credit Card Information
Visa ___ Mastercard
___ Discover ___
Card Number _____ _____
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Exp date ________
Signature _________________________________
Date __________Security code________
Name on card_____________________________________Please print Billing address on card___________________________________________
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