Pine Ridge Gardens
. . . . . helping restore the earth
832 Sycamore Road
P O Box 748(mailing address)
Dardanelle, Arkansas 72834
479-970-9143
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E-mail:   pineridgegardens@gmail.com
You are welcome to print this page and use it to place your order. Please be sure all information is complete, such as name, address & date you want your plants
You may place your order now and We will reserve you plants for you!  (within reason)
Date_____________ Week you would like to pickup your plants. _____________
Name_____________________________________________________
Address_______________________________________
Shipping address ___________________________________
City, State & ZIP ____________________________________________Hardiness zone_____
Phone ________________________________
E-mail _____________________________________________

Many plants are available in limited quantities only. With the online catalog prepared in advance, things can happen to plants to make them unavailable when you order. If this should happen, do you want:
a refund __    a substitute __    duplicate plants __   (PLEASE CHECK ONE.)

Please advise if SIZE substitutes are not acceptable.

.

Orders are acknowledged by e-mail or snail mail.

  Special Instructions: __________________________________________________

 Quantity
 Name of Plant
 Price each
 Total
       
       
       
       
       
       
       
       
       
       
       
     Total Plant Cost:


 
 Sales tax is 7.5%


Credit Card Information

To: Pine Ridge Gardens
     
 

We treat your information securely and are compliant with the PCI guidelines.

Total Amount for plants ordered  ____________ 

 ____________ 

Total Amount to be charged  ____________

 Visa ___  Mastercard ___  Discover ___  Card Number _____  _____  _____  _____                    Exp date ________
    (Please check one) 

Signature _________________________________       Date __________Security code________
                                                                                                                   (on back of card)

Name on card_____________________________________Please print

Billing address on card___________________________________________


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