Text Box: Mountain Valley Dahlias 95629 Jerrys Flat Rd Gold Beach, Or 97444 541-603-1523

Text Box: Name_______________________________ Address_____________________________ City, State, Zip _______________________ email________________________________

Text Box: Make checks payable to:  Robert Chibante

Text Box: Wrap Label Order Form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

NAME

PHOTO

Y/N

INFORMATION REQUESTED ON LABEL

 ADS number, type, color, height, or other

AMOUNT
 

 

 

$10,00

 
 

W/o photo @.15 ea

W/ photo @ .20 ea

Setup fee 

Total Due
 

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