THE HOUSE OF PHALAENOPSIS

56 Wood Street, Lane Cove,
Sydney, NSW, Australia, 2066
TELEPHONE: +61 2 9427 3659
						Date: _________________

				ORDER FORM

PLEASE PRINT ALL DETAILS CLEARLY

Mr/Mrs/Miss ___________________________________________________________

Address _______________________________________________________________

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Post Code _____________  Phone Number _________________________________


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Quantity		Description		Plant	Unit	SUB
						Size	Cost	TOTAL
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						 Freight Cost: ________

							TOTAL: ________

					     Payment Enclosed: ________
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PLEASE CIRCLE ANSWER

May we substitute a similar variety?	 Yes	No

May we substitute a different pot size?	 Yes	No


SIGNED: _________________________________________ DATE: ______________