CRAZY DAHLIA LADY
78 Ephrata Ave NW
Soap Lake,  WA 98851

509) 246-1462
crazydahlialady@aol.com

DATE: ___________________

NAME: _____________________________________________________________________

ADDRESS: ___________________________________________________________________

CITY:___________________________STATE _______________ ZIP CODE: ____________

PHONE: ___________________________  Email: ___________________________________

SHIPPING DATE: __________________________

Quantity

Item No

Name Of Variety

Price

Total Price

Shipping charges:                                                            Sub Total:   $ __________.______

1-10 tubers add $6.00

    11 or more add $10.00          Shipping & Handling: $ __________.______

Shipments before March 1st add  $2.00 packing charge

Make Checks Payable to Robin Hood                                  Total:    $ ___________._____