| First Name: | Last Name: |
| Address: | |
| City: | Province: Postal Code: |
| Area Code: | Phone Number: E-mail: |
| Pick-Up | Delivery | Lilies | Daylilies | Peonies |
| Item | Quantity | Cost | Total |
|---|---|---|---|
*Shipping & Handling: |
Subtotal 1: | ||
| Discount: | |||
| Subtotal 2: | |||
| Shipping & Handling*: | |||
| Subtotal 3: | |||
| GST 5%: | |||
| PST 8% (Ontario Residents): | |||
| HST 13% (NS, NB and NF): | |||
| Overall Total: | |||