Wild Iris Rows Order Form

Name

First

Last
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Email
Phone Number

###
-
###
-
####
Iris Varieties Requested (Quantity, Name, Cost)
Please list quantity, name, and total cost for each variety (i.e. 2 Ample Charm $8)
Substitutions (Optional)
You may list possible substitutions in case we are sold out of certain varieties.
Iris Total
Shipping
$10 for the first 10 plants plus 25 cents for each additional plant
Total Cost
Payment Method
 PayPal 
 Money Order 
 Check (before August 1st) 
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]

Powered byEMF Form Builder
Report Abuse