SIMPLIFIED ORDER FORM 
SHIP TO 
ADDRESS CITY ZONE STATE 
Ship by:--- Parcel PostL___] 2na, Class ExpressL___] Motor Lrucke sin es [Rerere| 
(eeu ah FreightL___|to Shippers Own Otecreticn jem] see anh [eat 
(PLEASE REFER TO PRICE LIST FOR SHIPPING INSTRUCTIONS) 
Quantity Discription Unit Price Total Price 
lts, Grade A, Natural Cleened Moss $ : per lb. $ 
lbs, Grade A, Naturel Un-cleaned Moss $ . per lb. op i ee ee 
lbs, Grade B, Natural Cleaned Moss $ ; per lb $e ee ee 
lbs, Chrome Yellow Moss (Dyed) $ per lb $ ; 
ibs, Chinese Red Moss (Dyed) $ : per lb. $. ‘ wld 
lbs, Forest Green Moss (byed) eee Dele Dy i Me Maan 
lbs, Chartruese Moss (Dyed } (inant enlatich O12) GF) diy as 1 lide Bee aati 
OZ, Oak Lichen Moss } ; per 02. ee ee 
Lies Oak lichen Moss $ j per lb. po Se ae 
pcs, Regular Small Manzanita $ - DERE ea. $ 
pes, regular Medium to Large Manzanita $ ; per ea. So eee 
pes, Regular Miniatures Manzanita oa per ea. $ ‘ 
pcs, Ivory White Small Manzanita $ : per ea. $ , 
Doe, Ivory White Med to Lge Manzanita $ : per ea. ee a ee ee 
TOTAL COST = $ 
AVOUNT FNCLOSED = § ; 
§ 
C.0.D. BALANCE 
Disa eearT onal Ti tems here 
DATE OF THIS ORDER 
NEVADA MING TREE COMPANY 
WHEN WANTED 
SSS 2 I SD 
P.O. BOX 373 RENO, NEV. 
SIGNATURE OF CUSTOMER 
A TE SE EESTI 
