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PLEASE PRINT THIS ORDER FORM, COMPLETE, AND MAIL or FAX
Bluegrass Daylily Gardens, 4122 La Grange Rd, Shelbyville, KY 40065
phone: (502) 633-6471

Name

Address
City
State
Zip
Phone
Email
Shipping Date
We ship by USPS Priority Mail - $25 minimum order
May We Subsitute?    Yes No
METHOD OF PAYMENT
Check Enclosed       Money Order Enclosed        Payment through PayPal 

QTY
CULTIVAR
PRICE


QTY
CULTIVAR
PRICE
1 12
2 13
3 14
4 15
5 16
6 17
7 18
8 19
9 20
10 21
11 22
Gift Certificate Amount
Sub-Total
($12 plus $0.50/plant after 3 plants) Postage
6% sales tax for KY residents
Checks payable to Chuck Williams                TOTAL