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	Print and complete this form and mail check or money order to: Juniata Stinking Rose 719 Washington Ave. Mifflintown, PA 17059


	GARLIC ORDER FORM

Name:_________________________________________ Address:_______________________________________ City/State/Zip:__________________________________ Phone:________________________________________
TYPE	AMOUNT (in pounds)
Artichoke French White (softneck)
Mchadidzhuari (softneck)
German White (hardneck)
Gambino Italian Purple (hardneck)
Romanian Red (hardneck)
Total (pounds)
Cost per pound ( $8 ) ___ X $8
Shipping and handling $3.50 1st. lb. $1.50 each additional lb.
Total $

Send Check or Money Order with this form to:

Juniata Stinking Rose

719 Washington Ave.

Mifflintown, PA 17059