SILVERTON -OREGON 



Date- 



.19- 



SHIP TO 



STREET OR R^J>. 

 CITY 



-STATE. 



.ZIP NO. 



AMOUNT ENaose>- 



PLEASE INOUUE 600 FOR 

 HANDIINO ANr> PACIftNO 



DATE WANTED- 



MINIMUM ORDER $5.00 



QUANTITY 



NAME OF VARIETY 



PRICE 



QUANTITY 



NAME OP VARIETY 



PRICE 



































































































































































































































































































(CONTINUE ORDER IN OTHER COLUMN) 



TOTAL 









TOTAL 







SUBSTITUTIONS will not be mode unless you request. If supply 

 of a variety you hove ordered is exhausted, may we send you 

 another, of equal or greater value? Please answer . . . 



YES □ NO □ 



Total From First Column 







Packing and Handling 







GRAND TOTAL 







om 



> O 

 r n 

 ' m 



Iz 



p m 



ft 

 m 

 M% 



> 



INCLUDE ZIP CODE NUMBER -IT WILL HASTEN DELIVERY 

 POST OFFICE INSISTS ZIP NUMBER BE USED ON ALL MAIL 



