Willeman's Flowers Mail Order

Willeman's Flowers & Decorators

ORDER FORM

P.O. Box 203 Co. Rd. 17D
Okolona, OH 43550
(419) 758-3226 or (800) 550-3991

email: willeman@bright.net Fax: 419-758-3446

PRINT OUT AND COMPLETE THIS FORM

.	Quantity	Description	Predominant Color - White or Ivory	Accent Colors	Size.	Price	Total
Ex.	1	Sweetheart Cascade Bouquet	ivory	burgundy & gold	Lg.	75.00	75.00
Ex.	1	Arm Bouquet	white	plum & silver	Med.	45.00	45.00
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.				Total Order		$
.				Ohio Residents 6% sales tax		$
. .				Shipping & Handling (listed below)		$
. .		Minimum Order $25.00		Total Amount Due		$

Please send accent color sample. We can match any color.

Shipping Information:

Deliver to:

Name__________________________________

Address______________________________

_____________________________________

City_________________________________

State________________________________

Zip__________________________________

Phone - daytime______________________

Phone - evening______________________

Method of Payment

Check or M.O._________________________

Master Card __________________________

Discover ____________________________

American Express _____________________

Visa ________________________________

Exp. Date_________

Signature_____________________________

Sorry No C.O.D.

S & H

$40 or less $2.95

40.01-75.00 3.95

75.01-100.00 4.95

Over $100 Shipped free

** Please Allow 4-5 weeks for Delivery **

** Money back guarantee if returned within 10 days **