ROBERTA’S PLANT ORDER FORM
Phone or Fax Orders
Ph: 1-800-428-9726 ext. 2
Mail Checks to:
Roberta’s Gardens
P.O. Box 368
Waldron, IN 46182
Fax: 765-525-6923
BILLING ADDRESS (Please Print)
SHIPPING ADDRESS
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__________________________________________ HOME PH:_________________________________________
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__________________________________________ (We will only call if we have a question about your order)
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__________________________________________ EMAIL:____________________________________________
___________________________ZIP__________
______________________________ZIP__________
PAYMENT METHOD
Check
Money Order
CREDIT CARD #
Visa
Same as Billing Address
MC
Amex
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Discover
Expiration Date:_______/_______ Security Code: _____________
SIGNATURE_______________________________________________________________
QTY
SKU #
ITEM DESC.
PRICE
PLANT TOTAL
SUBTOTAL
7% SALES TAX(IN. ONLY)
GRAND TOTAL