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Outback Greenhouse Speciality Planters
Customer Order Form
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* Indicates required question
Name:
*
Your answer
Telephone:
*
Your answer
Container Description
*
Your answer
Which location will you pick your order up from
*
Drenthe Location, 1134 64th Ave.
Holland Location, next to VanWieren Hardware
What type of environment will your container be in.
Full sun
Full shade
Morning Sun
Afternoon Sun
Other:
Clear selection
Preferred colors
Reds
Pinks
Oranges
Yellow
Multicolored
Clear selection
Would you like extra greens?
Grasses
Ivy
Creeping Jenny
Spike
Sweet Potato Vine
None
Clear selection
Date requested for pick-up ( a minimum of 1 week after container has been received at Outback Greenhouse
MM
/
DD
/
YYYY
Any other special instructions
Your answer
Any other plants or baskets requested with this order
Your answer
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