Exp. date: Sec.Code:
Signature:
Total:
MI residents add 6% sales tax:
SHIPPING (See Info)
(Usually, $14 Ground, $16 Air)
AMOUNT ENCLOSED:
| ENSATA GARDENS 9823 E. Michigan Avenue Galesburg, Michigan 49053 269 665-7500 Fax 269 665-7500 (ensata@aol.com) |
We will ship by PRIORITY MAIL unless otherwise instructed |
| Name: __________________________________________________________________ |
| Address:________________________________________________________________ |
| City State ZIP: ___________________________________________________________ |
| Phone: _______________________we acknowledge by E-Mail: ____________________ |
| Date Wanted: |
(If sold out of a variety, may we substitute for equal or greater value for the same price? ( Yes, No, refund)
|
Qty |
Variety (Use back or additional paper) |
Price |
| Discount or Books: | ||
| Siberian Collections @$39 Color Range, etc |
|
|
# Exp. date: Sec.Code: Signature: |
Total: |
|
|
MI residents add 6% sales tax: |
||||
|
SHIPPING (See Info) |
||||
|
(Usually, $14 Ground, $16 Air) |
||||
|
AMOUNT ENCLOSED: |