FREY’S DAHLIAS

12054 Brick Rd, Turner, OR 97392

Phone: (503) 743-3910 Web: www.freysdahlias.com

BE SURE TO LIST SUBSTITUTIONS OR 2nd CHOICES ON ORDER

Name _________________________________________Date___________

Address______________________________________________________

City_________________________________State _______Zip__________

Phone (______)________________________________________________

QTY_______VARIETY ______________________PRICE

_____|__________________________________________|______

List 2nd choices here_______________________________________________________________________

_____Refund if variety unavailable

_____I will pick up order (no ship charge) (We will notify you when ready) Subtotal_________

Shipping & Handling ($3; 1-3 tubers), ($6: 4-10 tubers)

Or ($10 for 11 or more tubers) any zone S&H ____________

(All orders shipped in April/May) Call if you want another date. Total ____________

Pymt: ____Check ____ Visa ____ MstrCd ____ Amex ____ Disc ____ MONEY ORDER

Card #________________________________________Exp__________CVV Security #’s on card _________

Signature__________________________________________________________________