Heirloom Roses   Order Form 2005  

 P.O. Box 9106, Stn. A Halifax, NS  B3K 5M7                             Phone: 902-471-3364

 Farm: 161 Pockwock Rd. ( Off Hammonds Plaind Rd.)            Fax: 902-835-0653

 Hammonds Plains, NS  B4B 1M6                                                 E-mail: office@oldheirloomroses.com 

 

   NAME (please print)_________________________________________________________________________

 

 SHIPPING ADDRESS ________________________________________________________________________________

 

  CITY__________________Prov./State____________________Postal Code/Zip ___________________________________

 

  PHONE______________________FAX________________________E-MAIL*____________________________________

 

Quantity	Cat. #	Variety (Plant  or Product Name)	Price Each.	Total

 

Shipping and Handling: click on hyperlink to view our shipping schedules. Please email or call should you have any questions about ordering before submitting this form.  U.S. Residents please read our shipping instructions under U.S. Orders.   * credits include catalogue refund paid, gift certificates (please include) etc.

1. Subtotal  of order above                                  ___________________________ 2.  Shipping charges (see box )                                                                                           3. Subtotal : (lines 1 + 2)                                     _______________________         4. Credits (minus any credits)                        -_________________________  5. subtotal:  (lines 3 minus 4)                          ______________________ 6.HST 15 % of line 5 (NB, NS, PEI, NL only )  __________________________ 7. GST (7% of  line 5 (all other Provinces) ___________________________ 8. U.S Residents only Phytosanitary inspections fee:     $ 10.00___  per order 9.Total enclosed                                               ___________________________

 

Thank you for your order.  We value your business !