No title

ONLINE PURCHASE ORDER

Enter the information requested, products you wish to order and submit

Please ensure you advise your telephone number so that you can be contacted to confirm your order
and to ascertain your credit card details

Heirlooms / Barberry Row - Online Purchase

Name:

Address:

City:

State / County:

ZIP / Post Code:

Country:

Email :

Telephone (Day):

Telephone (Evening):

Fax :

Mobile:

When ordering, please quote the following -
Code & Code Number	Description / Design Title / Colour Name	Quantity	Price (ea) NZD
SP10 112	: Wild Violets	: 1 :	12.00
SP05 072	: Plum Honey	: 1 :	14.00
BARB 002	: Floral Silhouette	: 1 :	19.50

Purchase Order:

Remarks / Comments

If you have any queries, please do not hesitate to contact me
(preferably by telephone or fax)
Thank you. Sherelyn

Phone & Fax: +64 6 878 1260

Email: barberryrow@clear.net.nz
(Note: Please advise your phone number & address when Emailing. Thank you)

	Products required for .....
Flowers for Sherelyn Band Sampler	Floral Silhouette	Silken Roses Needlebook

A Friend Loveth At All Times	Grape Companions

Barberry Row � Wyndom House � 1821 Pakowhai Road � R.D. 3 � Napier 4183 � New Zealand
Phone & Fax: +64 6 878 1260

Gallery Hours: Fridays ~ 10am - 4pm (or By Appointment)

(Note: Please advise your phone number and address when Emailing. Thank you. Sherelyn)