Mail or Fax Order Form

As an alternative, you can print out the shopping cart

Please fill out information below, print, and mail to: (phone/fax orders welcomed)

Moonshine Designs Nursery

9518 27 Street

Milan, IL 61264-3512

Phone:  309-756-1967    Fax:  309-756-1058

Purchaser
Street Address
City State Zip
Telephone
Email: 

Part # or Size
Description
Qty
Unit Price
Total
Subtotal
Shipping **
If shipment is going to Illinois, ADD 6.25% IL Sales Tax
Total

**Please use the shopping cart to calculate the shipping

Terms: Check, Money Order, COD, Discover, Visa, MC.  CVC# required on ALL Cards*

Credit Card CVC #
Bank# Exp. Date

 
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Questions?

*The CVC number is located on the back of the card in the signature band.  It is the last three numbers.

Shipping address and the billing address for your credit card must match.  We cannot ship to a different address if using a credit card.  If this is required, please send check or money order.

If you desire shipping at a later date, it must be specified with the order!