American Clematis Society


	Sold to: 	Please Print			       

	Name:______________________________________________


	Street:____________________________________________								


	City:__________________ State:_______ Zip:_________




	Ship to (if different from Sold To): 		

	Name:______________________________________________


	Street:____________________________________________								


	City:__________________ State:_______ Zip:_________


		Product                   Quantity       Price
		
		_______________________________________________

		_______________________________________________

 		_______________________________________________

		_______________________________________________

		_______________________________________________


		CA residents only add 7.75% sales tax.				
		Shipping and Handling $4.00 per order.

		All orders over $20.00 are eligible for free shipping.


                               Subtotal:_______________

                                    Tax:_______________

                               Shipping:_______________

                                  Total:_______________


Send your check/money order payable to the American Clematis Society to:
 
 
   American Clematis Society
   P.O. Box 17085
   Irvine, CA 92623-7085
   US

Allow 2 to 3 weeks for delivery.