Customer Name and Address                          Foliage Gardens
                                                      2003 128th Ave. S.E.
                                                      Bellevue, WA 98005
                                                      (425)747-2998




   Phone Day______________ Evening_____________ Email________________________
   Order Date______________ Date Desired__________
   Please do not ship between ____________________________________________
   Check here if you would like to pick up your plants at the nursery_____
   If we are sold out would you prefer? Substitutions ___ (please list on the
     back) Credit Memo ___ Refund ($4.00 min)___

     QTY                Plant Name                          EACH     Total
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                                 (Minimum $20.00) Subtotal Ferns    ________

                                                  Shipping Ferns    ________

                                                            Book    ________

                                WA State Residents 8.8% Sales Tax   ________

                                                           Total    ________
   PLEASE REMEMBER SHIPPING DOES NOT BEGIN UNTIL EARLY MAY