Print Order Form
 Print this form, fill it and mail or fax it once completed.
Or use the secure online form.

129  Augur Hole Rd.    South Newfane,     VT   05351
Tel: (802) 348-6614 - Fax: (802) 348-9881 - info@daylilygarden.com

Customer Information
Customer's Name:
Street Address:
 
Town:
State:
Zip:
Tel:
Town:
Email:
Ship to Name: (if different)
Street Address:
 
Town:
State:
Zip:
Tel:
Email:

Quantity Item Name Size Price Each Item Total
Sub Total (minimum $40)
VT Shipping Address 6% Sales Tax
Shipping Fee (see below)
Total of Items 
Total Enclosed
Shipping Fees (within USA)
Purchase Amount Regular Ground 3 Day UPS 2nd Day Air
$30 - $100 $11.00 $26.00 $42.00
$101 - $200 $13.00 $28.00 $44.00
$201 and above $16.00 $31.00 $47.00
We recommend 3 Day to locations west of Rocky Mountains.
Ordering Information
Date Ordered:
Preferred Ship Date:
Preferred Ship Speed:
Regular Ground 3- DAY UPS 2nd DAY AIR
May We Substitute? yes           no
Only plants of equal or greater value will be substituted
Use the space below for your Substitution wish list

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Is this a gift? yes        no
If yes, please fill out the gift section below:
Should we include a catalog? yes     no
Should we include a receipt? yes     no
Should we include a gift card? yes     no
We will write your personal message inside. Cards are $3.25. Or you can include your own card in this order.
Please write your message here:
We have lovely gift certificates in any amount. If you would like us to send a gift certificate to someone, please write the name of the recepient below. Put gift certificate on one line of the order blank. There is no tax or shipping charges on a gift certificate. We will send a free catalog with the certificate if you wish:
Gift Certificate to:
Amount: $
Street Address:
Town:
State:
Zip:
Email:
Payment Information:
   Visa   Mastercard
Credit cards will be charged when order is received
Card number:     
Exp. date:
Name on card:
Free Catalog to a Friend:
Name:
Street Address:
Town:
State:
Zipcode: