Drointon Nurseries Order Form

Personal Details:

Name: _________________________________
Address: _________________________________
  _________________________________
  _________________________________
  _________________________________
Postcode: ________________
Telephone: _________________________________
E-Mail: _________________________________
Please tick if you would like advice on growing auriculas:

Payment Details:

1. Cheque enclosed with order:

 (Please write all cheques out to 'Drointon Nurseries' )
2. Please invoice when plants are ready:
3. Card payment:

Card Details:

Visa
Mastercard
Visa Electron
Maestro
Delta
         
Card Number:
Valid From:
Expiry Date:

Security No:

 (last three digits on signiture strip on back of card)
Cardholder Name: _________________________________
Signiture: _________________________________
Date:

Delivery Details:

Royal Mail First Class:
Next Day Carrier:
Collection By Appointment:

 


Quantity
Plant Name
Price Each
Total Price
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       

Sub Total:

Postage & Packing:

  

Total:

  

 

Rec.
O/No
CID
InvD
Pay Rec
Desp

 

 

 

 

Drointon Nurseries, Plaster Pitts, Norton Conyers, Ripon, North Yorks. HG4 5EF

Tel: (0)1765 641849