PEEKSKILL NURSERIES
P.O. Box 428
Shrub Oak, New York 10588
914-245-5595

PRINTABLE
ORDER FORM

Print out this form and
mail it to us with your check

NOTE: We ship to the 47 continental United States ONLY
However we do not recommend shipment or guarantee livability of plant material shipped to Florida, Texas, Arizona or Nevada. We do not ship to California.
ORDERED BY: (your mailing address) SHIP TO: (correct address for UPS shipments)
Name: Name:
Address: Address:
Address: Address:
City: City:
State: Zip: State: Zip:
Phone:     (          )           – Phone:     (          )           –
Name of Plant
Quantity  TOTAL
     
     
     
     
     
     
Total 
New York Residents please add correct Sales Tax   
PLANTS ARE SENT VIA UPS GROUND. See our Shipping Page for UPS Rates, and insert Shipping & Handling Charge in this box. Exception: For orders shipped more than 1,000 miles from New York, we recommend adding $10.00 + 12% of total order for 3-day UPS Select shipping   

GRAND TOTAL  		  
Preferred Delivery Date:
  
Please make check payable to Peekskill Nurseries
Thank you for your business!

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