To place an order fill out this form on your computer screen, then PRINT OUT a copy and MAIL OR FAX it to Prairie Habitats Inc.


SEND TO:

Prairie Habitats Inc.
PO Box 10
Argyle, MB R0C0B0
Canada

CONTACT INFO:

Ph: (204) 467-9371
Fax: (204) 467-5004
Email: jpmorgan@mts.net
GST# 893487470RT

ORDERED BY:

Name:

Prov. / State:

Address:

Postal / Zip Code:

City:

Phone #:

Live Plant Orders: Sorry, we no longer produce live plants, just seed.

#
Name of Item
Price
Off. Use

1

2

3

4

5

6

7

8

9

10

11

12

13

Subtotal 1:

Shipping (see below):

Subotal 2:

(Canadian residents only) Add 5% GST on Subtotal 2:

(Manitoba residents only) Add 7% PST on Subtotal 1:

Grand Total (Amount Enclosed)


Method of Payment

Cheque or Money Order

Shipping Costs (Growing instructions included with each order):

Visa Mastercard

Expiry Date:

Card #:

to $10.00 = $3.50
$10.01 to $25.00 = $6.00
$25.01 to $50.00 = $8.00
$50.01 to $75.00 = $12.00
$75.01 to $100.00 = $15.00
$100.01 + = 15% of Subtotal

USA & International Orders - shipped at cost via insured parcel post with VISA or MasterCard only. An additional CA$25.00 phytosanitary certificate required by USDA on large, bulk (one lb or more) seed shipments to the USA.

Signature: _______________________________
(on printed copy only)

 

Card Holder's Name (Please Print):


THANK-YOU FOR YOUR ORDER & HAPPY PLANTING!!

Prices are subject to change without notice

Print a second sheet if you need more space. Include price totals on one sheet only.

Be sure to review your printed order for accuracy and remember to include your payment information page with your order. Print a second copy of this order for your own records.