Walt & Cory Wynne
1395 Willey’s Lake Rd
Ferndale, WA 98248
Tel: (360) 384-3439
**Please make checks payable to WYNNE'S DAHLIAS**

ORDER DATE: ______________________ 

NAME:______________________________________________________________

 ADDRESS: __________________________________________________________

 CITY:_______________________STATE ___________ ZIP CODE: ____________ 

PHONE: __________________________  Email: ____________________________ 

SHIPPING DATE: __________________________ 

 Name of Variety Quantity Price Total of Item
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    

 Subtotal $__________________                                                                                                                                                                                   

 Add Shipping  $ _____________          (please see our website under "price list" for shipping charges)                                                      

 

Total Amount Due $_________________