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Valleygrowers Nursery Order Form
Valleygrowers Nursery Order Form
Please enter the quantity for each item you would like to purchase.
Order Details 1:
Species / Variety / Item:  
Size (if applicable):      
Quantity:                  
Price:
Order Details 2:
Species / Variety / Item:  
Size (if applicable):      
Quantity:                  
Price:
Order Details 3:
Species / Variety / Item:  
Size (if applicable):      
Quantity:                  
Price:

Thank you very much for your order. We will call you within two working days to provide details as to your order's fulfillment dates.

Credit Card Number: Exp.Dt: mm - dd - yy

Billing Address:
First Name:          
Last Name:           
Organization:        

Street Address 1:    
Street Address 2:    
Apartment #:         
City:                
State/Province:      
Zip/Postal Code:     
Country:             
Phone:               
Fax:                 
E-mail:
If the shipping address and the billing address are the same, please check here and leave the shipping address blank.

Shipping Address:

First Name:          
Last Name:           
Organization:        

Street Address 1:    
Street Address 2:    
Apartment #:         
City:                
State/Province:      
Zip/Postal Code:     
Country:             
Phone:               
Fax:                 
E-mail:

Our E-mail address is:
vlygrwrs@web-ster.com

Fax to: (503) 651-3044