Order Form
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Gift Information
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   If Other:

TO:
*Name of Honored Person:
Nickname:
*Type: Male Female Couple Pet
*Age at Death: 0-1 year 2-10 years 11 to 20 years
21-50 years 51 years and up Unknown
*Given By:
*Choose Card Number:   See Card Selections
*Choose Letter Number:   See Letter Selections
Personalized Message:
(Personal message to go
on card - optional -
30 word maximum.)
*Plant Tree(s) In:
. .
MAIL CERTIFICATE AND ACKNOWLEDGEMENT TO:
*Title: Mr. Mrs. Ms. Dr.
*Full Name:
*Address:
*City:
*State/Province: *Zip/Postal Code:
*Country:
. .
*GIFT ITEM: .
Plant 1 Tree... $29.95 US Dollars
Plant 3 Trees... $59.95 US Dollars
Plant 5 Trees... $99.95 US Dollars
- Quantities of 10, 15, 25 or 50 trees include a frame -
Plant 10 Trees... $150.00 USD (with cherry finish frame)
Plant 15 Trees... $190.00 USD (with cherry finish frame)
Plant 25 Trees... $250.00 USD (with cherry finish frame)
Plant 50 Trees... $400.00 USD (with cherry finish frame)
.
Add a Cherry Finish Frame... $17.95 US Dollars
. .
Special Instructions:
(additional cards &
certificates, address
changes, alternate
recipients, etc.)
. .
YOUR PERSONAL
BILLING INFORMATION:
*Full Name:
*Address:
*City:
*State/Province: *Zip/Postal Code:
*Country:
*Phone:
*E-Mail:
. .
*Payment Via: MasterCard VISA American Express
*Card Number:
*Card Expiration: MMYY
. .

 

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