SPECIAL ORDER BLANK 
TO 
GRASSYFORK, INC. 
(Established 1899) 
MARTINSVILLE, IND., or SADDLE RIVER, N. J. 
(Send Order to Nearest Point) 






DATE SHIP BY 
STATH BY PXPRESS OR PARCEL POST 
NAME 
ME:—MRS.—MISS 
ADDRESS 
STREHT—P. 0. BOX—R. F. D. 
CITY 


EXPRESS OFFICE 

COUNTY STATE 

PLEASE DO NOT WRITE HERE 
ORDER NO. AMOUNT ENCLOSED: CASH CHECK 

AMOUNT OF ORDER AMOUNT OF POSTAGE 


TERMS: CASH WITH ORDER. NO C. O. D. 
WATER LILIES, PLANTS, Etc., are shipped F.O.B. with ALL Charges PREPAID 






QUANTITY NAMES OF ITEMS ORDERED HERE 
DOLLARS 
CENTS 
































AMOUNT OF ORDER 


Plus 10% For Handling, Packing and FULLY PREPAID Transportation Charges 
(25c Minimum Charge) 





TOTAL AMOUNT ENCLOSED 




FOR CONDITIONS OF SALE AND SHIPPING INSTRUCTIONS SEE OTHER SIDE 
WE GUARANTEE ALL PLANTS TO GROW! 
bes * 
