ORDER FORM
           1685 Magnolia Drive, Healdsburg, CA 95448
              (707) 433-7455 | FAX (707) 433-5683 
                 info@russian-river-rose.com

 

    Please print and mail (with payment) or FAX.
                Minimum Order $28


ORDERED BY:                     date: ______________
Name   _____________________________________________
Street ____________________________________________ _
       _____________________________________________
City _______________________ State______ Zip: ______

Telephone: (_____) _______________
E-mail_____________________________________________

SHIP TO: (if different from above)
Name   _____________________________________________
Street ____________________________________________ _
       _____________________________________________
City _______________________ State______ Zip: ______

Telephone: (_____) _______________
E-mail _____________________________________________

Will pick up from RRR Co on _____________________


PRODUCTS:

PRODUCT                       QUANTITY    PRICE      TOTAL

Pruning Workshop              ______    $30.00 ea.  ______
Propagation Workshop          ______    $ 5.00 ea.  ______
ToolBelt                      ______    $34.95 ea.  ______
1/6 oz. Eau de Toilette       ______    $30.00 ea.  ______
1/6 oz. Eau de Toilette boxed ______    $31.50 ea.  ______
2 oz. Rose Water              ______    $12.00 ea.  ______
2 oz. Rose Water w/spritzer   ______    $15.00 ea.  ______
4 oz. Rose Water              ______    $20.00 ea.  ______
                                           SUBTOTAL ______
(no sales tax on Pruning Workshop fee)
SHIPPING= $ 0.00 with pick up
SHIPPING= $ 9.95 for order of $28-$53
SHIPPING= $11.95 for order of $54-$78
SHIPPING= $13.95 for order more than $78
SHIPPING TOTAL
                                   8.5% CA SALE TAX ______
                                        GRAND TOTAL ______

PAYMENT METHOD:
/__/ MasterCard Visa only
      CARD NUMBER              EXPIRATION DATE     SECURITY CODE
                                               (MM/YY)
      ______ _______ ______ ______      ____/____                  _______

      CARD HOLDER NAME________________________________

/__/ CHECK ENCLOSED Made out to Russian River Rose Co.