Daisy Farms - Secure Order Form

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Home Strawberries Raspberries Blueberries Blackberries Asparagus Rhubarb Horseradish

Daisy Farms

28355 M-152

Dowagiac, MI 49047

To Order by Phone or Fax call:

Phone: 269-782-6321

Fax: 269-782-7131

ABOUT SSL CERTIFICATES

Secure Order Form

We assure prompt delivery when ordered items are available as requested.

Ship To:

Use your tab key to move from item to item on the order form. Don't use the "Enter" key. When order form is complete, click on 'Submit form' once to send order.

Please Include A Phone Number On All Orders!!

Name
E-mail
Address
City
State	Zip
Daytime Phone#
Fax
Evening Phone#
Date of Order
Will pick up at nursery
Ship Plants on or ABOUT date:
We will ship by UPS unless otherwise specified, UPS will NOT deliver to your Post Office Box, so please make sure to list a shipping address.
Quantity	Type of Plant	Price Each	Total Price
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UPS Shipping Charges (MINIMUM Shipping Charge $10.00) Shipping prices apply only to lower 48 states. USPS Priority Mail rates apply on shipments to Alaska & Hawaii.

Item Name	Add to Order
Asparagus	25%
Horseradish	15%
Raspberries	15%
Rhubarb	15%
Strawberries	15%

Terms of Payment

VISA / Master Card		(Figure the total) -- Sub-Total
Card Number		15% UPS
Card Expires		25% UPS Asparagus,
On the back of your credit card, there are 7 numbers in the signature strip. Please enter the last 3 numbers here.
*Order must be paid in full before shipment date.*		TOTAL

We appreciate knowing where our advertising dollars are doing the most good.
Please take a moment and let us know how you heard about Daisy Farms.

Thank You!

To prevent delays in shipping your order, please double-check all information entered on the order form, including your credit card number, before clicking once on the 'Submit Form' button.

We will send you a confirming email when you order is received.

Privacy Statement

We do NOT share our customer's information with anyone. You can be assured that we will maintain your privacy.