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Reference number
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Quantity
|
Item price
|
|
Plants price.................
|
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Shipping costs................
|
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TOTAL AMOUNT..........
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€
|
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I pay with;
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Cheque/Eurocheque
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Postal order
|
Credit card
|
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Surname
|
|
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First name
|
|
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Adress
|
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Credit card N°
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Name of card holder
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Expiry date
|
|
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Signature
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