Please Print form to order by mail

PLANT PRICES: Streptocarpus - $6.50 unless otherwise noted
Episcia - $5.00 • Kohleria - $5.00
SPECIAL OFFER: 10 DIFFERENT PLANTS
MY CHOICE - $35.00 plus shipping
WHOLESALE PRICES: 30+ PLANTS - $3.50 each plus shipping		 SHIPPING: ALL SHIPMENTS ARE BY USPS PRIORITY MAIL
APRIL 1ST TO NOV. 1ST OR WEATHER PERMITTING
$12.00 + 25¢ PER PLANT OVER 10.
LARGE WHOLESALE ORDERS PAY ACTUAL SHIPPING COSTS

Note: Minimum order is 6 plants. Free Gift with every purchase.

Quantity  

Variety Name

Office

Use

Only

Price Each

Total
Plants    

Sent

Sub

Refund

    
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               

TOTAL    

$
Please complete this order form and mail to:
Gary S. Mikita, OUT OF AFRICA • 2842 Brown Street • Portage, IN 46368

Date_____________________

ORDERED BY:

Name________________________________________

Address_______________________________________

City____________________ State_____ Zip__________

Phone Number__________________________________

Email Address__________________________________

 SHIP TO:

Name________________________________________

Address_______________________________________

City____________________ State_____ Zip__________

 

Have you ordered from us before?    [] Yes   [] No

PLEASE INDICATE METHOD OF PAYMENT
Enter Total from Above: $_______________________


Shipping Charges: $____________________________
(All orders are shipped USPS Priority Mail)
$12.00 + .25¢ per plant over 10


Subtotal:__________________________

 [] Check  [] Money Order  [] Visa [] Mastercard  [] Discover

For Credit Card Orders Only:

Card #_________|_________|_________|_________

Expiration date: _____/_____ (MM/YY)

Three digit security code: ____  Four digit code (American Express only)____

Signature____________________________________
 

Credit cards

Sales Tax: IN Residents add 7% $_____________

ALL PLANTS ARE SHIPPED IN 2½ OR 3” POTS.
DISCOUNTS GIVEN TO CLUB SALES
Total Enclosed $______________________


Phone / E-mail Orders Taken________________


 

If we are out of varieties you have selected, should we:

[] No Substitute
[] Substitute with Out of Africa's choice
[] Substitute with the following:

______________________________________________

______________________________________________

______________________________________________
 (If no indication is made, we will substitute, or issue credit.)