Order Form 2007New !!!

Long Island's Home of Hosta

Mike & Dawn Koller

6 Classic Ct

Medford, NY 11763

lihosta@optonline.net

Please fill out the following order form, print, and mail to us along with your payment made out to Long Island's Home of Hosta. We accept checks or money order only. Minimum order is $30.00. N.Y. residents, please add 8 3/4% sales tax. Thankyou for your order!.

Mailing Address

Name: 
Address: 
City,State,and Zip: 
Phone:  Email: 

Shipping Address(If Different)

Name: 
Address: 
City,State,and Zip: 

 


Preferred Shipping Date(Indicate First and Second Choice)

First Choice      Second Choice 
   



Qty 

Plant Name 

Cost Each 

Total 
    Subtotal: 
    NY 8 3/4% tax: 
   

Shipping&Handling=$8.00  
    Total: