Chapman Iris
8790 Wellington Road 124, Guelph,
Ontario N1H 6H7
(519) 856-0956
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Date:________________________________________ Telephone#:__________________________
Name: ____________________________________________________________________________
Address: __________________________________________________________________________
City: _____________________________________ Prov: _________ Postal Code:______________
E-Mail: _______________________________Your Agricultural Zone: ________________________
If out of variety - substitute? [ ] or Refund: [ ]
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Taxes Canadian residents 12% HST, NS, 13% HST ON, NB, NF , all other Canadian Provines, 5% GST
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