Chuck Chapman Iris
RR #1 (8790 WR124), Guelph,
Ontario N1H 6H7
(519) 856-4424
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Date:________________________________________ Telephone#:__________________________
Name: ____________________________________________________________________________
Address: __________________________________________________________________________
City: _____________________________________ Prov: _________ Postal Code:______________
E-Mail: _______________________________Your Agricultural Zone: ________________________
If out of variety - substitute? Yes: [ ] No: [ ]
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Quantity
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Name of Variety
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Amount
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Bearded? ____ Beardless? ____ Subtotal
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Shipping & Handling
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Ontario residents 8% PST
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NB, NS, NF - 14% HST; Other Canadians 5% GST
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TOTAL
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