THE LILY FARM ORDER FORM - Fill out, print, & mail!

NAME  
ADDRESS  
CITY/STATE/ZIP  
TELEPHONE  
EMAIL  
QUANT
NAME
PRICE
SUBT
TOTAL
METHOD OF PAYMENT
        Credit Card#     Exp.
Signature: _________________________________________
     
Subtotal
Tx Residents 6.25% Tax
Shipping & Handling (see below)
Please Remit Total
Desired Shipping Date: