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
______ $40.00 ea. ______
Propagation Workshop
______ $10.00 ea. ______
ToolBelt
______ $48.95 ea. ______
1/6 oz. Eau de Toilette ______ $34.00 ea. ______
1/6 oz. Eau de Toilette boxed ______ $35.50 ea. ______
2 oz. Rose Water w/spritzer ______ $16.00 ea. ______
4 oz. Rose Water
______ $24.00 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."