Alcovy Daylily Farm
P.O. Box 1753
Covington, GA
30015-1753
770-787-7177
Date:
 
Phone Number:
 
Name:
 
Address:
 
City:
 
State:
 
Zip Code:
 
Email:
 
May we substitute if sold out?
Preferred Ship Date:
 
Preferred Pick-up Date:
 
Shipping Method:
Priority
 
UPS
  
Circle one.     YES            NO
Subs. will be equal or greater value.
Please provide sub list on back of form.
Min. Mail Order: $50.00 (Plus S/H & Tax)              Please Make Check To : Jesse Burgess
Bonus Buy
Buying
Qty
Qty
Cultivar
Price Ea
Ext. Price
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
(Remember, if you
are picking up your
order, omit the $10.00
Shipping and the
$1.00 per plant
handling charge).
Plants are reserved only
after payment is received
Subtotal
  
(GA Residents Only)                                  Sales Tax 7%
  
(Shipped Orders Only)                                 Base Shipping
$ 10.00
(Shipped Orders Only)               $1.00  per plant shipped
  
Total Amount Due
  
Total Plants
Purchased
Total Free
Plants
 
 
 
X  $1.00
+
=
Total Plants
Shipped
Make check payable to :   Jesse Burgess