Fax or Mail Order Form

Welcome to the Manual Order Form.

Step 1: Please print out this form and fill out the details.

Step 2: Please enter your mailing address:

Name	______________________________________
Street Address	______________________________________
Apt. #	______________________________________
City	______________________________________
Province / State	______________________________________
Postal Code / Zip	______________________________________
Country	______________________________________
E-mail	______________________________________
Phone	______________________________________
Fax	______________________________________

Step 3: Please enter the recipient info:

Recipient Name	__________________________________
Recipient Address	__________________________________
Recipient City	__________________________________
Recipient Province / State	__________________________________
Recipient Postal Code / Zip	__________________________________
Recipient E-mail	__________________________________
Recipient Country	__________________________________

Step 4: Enter the quantity(ies) and total.

ITEM #	DESCRIPTION	QUANTITY	UNIT PRICE	ITEM TOTAL
`10`	`Gift Certificate $10.00`		`$10.00`
`20`	`Gift Certificate $20.00`		`$20.00`
`50`	`Gift Certificate $50.00`		`$50.00`
`100`	`Gift Certificate $100.00`		`$100.00`
`500`	`Gift Certificate $500.00`		`$500.00`
			TOTAL	$_______

Step 5: Please provide your payment method and details.

Card Type: AMEX MASTERCARD VISA

Card Number:______________________________________

Expiry Date (month/year format):_______________________

Name on Card:____________________________________

Authorization:_____________________________________

Step 6: Please either FAX or MAIL this form.

YOU CAN FAX THIS ORDER FORM TO:
	(905) 873-7305
YOU CAN MAIL THIS ORDER FORM TO:
	Sheridan Nurseries - RR#4 12302 10th Line, Georgetown, Ontario L7G 4S7 ATTN: GIFT CERTIFICATE