Poplar Wood Farm LLC

2010 Organic Transplant Order Form

Fill out this form and PRINT and mail or fax to:

Poplar Wood Farm, L.L.C. • P.O. Box 213 Port Murray, NJ 07865

Fax (908) 689-8736

Questions: (908) 399-7655 or email poplarwood.al@comcast.net
Name:
Business Name:
Address:
City:   State:   Zip:
Phone, Day:
Phone, Night:
Email:
Please check requested SHIP week:

April 19        April 26       May 3        May 10        May 17
Ship Address:

Check one

Same as above       Ship Address (fill out below)

Please check requested PICK UP Date:

Directions

Saturday, April 24     Saturday, May 1    Sunday, May 2      Saturday, May 8

Saturday, May 15       Sunday, May 16     Saturday, May 29

Hours for Pick-up          Saturdays 10-4          Sunday 12-4

Please note: NO PETS.  Children must be accompanied at all times.

In addition to organic transplants we will have flowering annuals & interesting container grown nursery stock available.
Substitute Instructions:

Sub with similar variety

Use Subsitutes Listed:

Sub 1:

Sub 2:

Sub 3:

Sub 4:

Plant Name Qty. Plant Name Qty.
Shipping Charges
Quantity  
12 $12.00
18 $18.00
24 $18.00
30 $22.00
36 $22.00
42 $26.00
48 $26.00
 
Plant Total Qty_____ X $3.50 Ea. $
NJ Ship To 7% Sales Tax $
Shipping Charges (see left) $
   
Grand Total $
Terms: Check, Money Order, Visa, Master Card
Name on Card
Card Number
Exp. Date
CDI /V-Code

CID/V Code is on back of card, it is the last 3 digits where you sign your name.

Check one

Credit Card Billing Address same as above

Credit Card Billing Address (fill out below)