ORDER FORM

Name:

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Phone:

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Date:

Qty.	Size	Item Description	Price	S&H

	Va. Residents add 5% sales tax:


	TOTAL:

Ship to:

Same as above: r

Name:

Address:

Gift Card: yes r no r

Message:

Method of payment:

Check r or money order r

payable to: Eastwoods Nurseries.

Visa r or Master Card r

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Expiration date:

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