The Wild Orchid Order Blank (Print This Page)

 Quan.   Item Number / Description Cost
 Each
  Total  
Cost
    
    
    
    
    
    
    
    
    
    
    
    
    
    
ORDER TOTAL   
Iowa Residents, add 6% Sales Tax   
     Shipping $7.00 or largest amount indicated   
ORDER GRAND TOTAL   

If Applicable:
VISA     MasterCard                                                                                           
Credit Card Account Number                                                      Expiration Date
                3 digit Security Code (CVV) _____________

Please PRINT names and addresses!       Date                                          
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Telephone:                                               E-mail:                                                   

The Wild Orchid
22957 - 280th Street
Adel, IA 50003-4491

PHONE: (515) 993-4841   FAX: (call first)   E-MAIL: orchidmini@aol.com