| Hortico Nurseries Postal Address: 422 Concession 5 East Waterdown, Ontario, Canada L0R 2H1 |
FAX: 905-689-6566 Phone:905-689-6984 |
This is the first page of a 2-page order form that you can print out, fill in, sign, and fax to us. |
| Billing Address | Shipping Address | |
| Name | ||
| Address | ||
| City | ||
| Province/State | ||
| Country | ||
| Postal/ZIP code | ||
| Phone | ||
| FAX | ||
| Email Address | ||
| Delivery Information | ||
| Delivery Method | UPS (USA) / Express Mail (Canada) / Courier / Our Truck / Customer PickUp | |
| Shipping Date | From: | To: |
| Payment Information | ||
| Payment Method | ||
| Credit Card Type | Expiration Date: | |
| Card Number | ||
| Signature | ||
| For Wholesale include USA IRS# or ONT. PST# | ||
| Instructions or Comments | ||
| |
||