Jan's Country Garden
344 O’Brien Road
Port Angeles, WA 98362


Phone: (360) 452-8287
Fax: (360) 457-6847
Cellular: (360) 477-6180
Email: janzgarden@myway.com
 

 

                                                       ORDER DATE: ________________________

 

NAME:______________________________________________________________

 

ADDRESS: __________________________________________________________

 

CITY:________________________STATE ___________ ZIP CODE: ____________

 

PHONE: ________________________  Email: ______________________________

 

REQUESTED  SHIPPING DATE: __________________________

 

Quantity

NAME OF VARIETY

Price

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     Shipping:  1-10 Tubers $5.95                          SUBTOTAL:_________._____

     11-15 Tubers   $6.95       16-20 Tubers $7.95

Over 20 tubers add $1.00 per every 5 additional tubers      SHIPPING: __________._____

       Washington Residents  Add 8.3% Sales tax          SALES TAX: _________._____
Mail order customers please remit by check or money
order (U.S. Dollars) and mail to the above address.          
    TOTAL: ____________.____