ORDER FORM

PLEASE PRINT OUT AND FAX OR MAIL WITH PAYMENT. Your name and address (BLOCK CAPITALS) Fax #: 732-252-6634

Mr./Dr./Mrs./Miss__________________________________ E-Mail ________________________

Street Address ______________________________ Daytime telephone ____________________

City _____________________ State _________ Zip__________ Country_________

Where did you hear about us?__________________________________________

Line#	Item#	Description	Quantity	Extended Price
1
2
3
4
5
6
7
8
9
10
11
12			1	FREE
Total of items above
Shipping & handling for plants and seeds in same box				8	95
or Postage, packaging and handling for seeds only				4	00
Subtotal
TOTAL

Custom message for promo packets: Max 2 lines up to 30 characters each line (including spaces).
METHOD OF PAYMENT	TOTAL PRICE
Check or money order (Make checks payable to Seeds of India, L.L.C.)
Credit Card (see below)
TOTAL PAYMENT

Please charge my credit card : MasterCard ___ Visa ___ AMEX ___ Discover ___ to my account number:

Expiration date: MO___ YR___ Cardholder Signature ______________________________________________
Fax to: 732-252-6634 or mail to P.O. Box 2244, Union, NJ 07083.
Please note: All fax orders will be confirmed by e-mail or fax within 24 hrs. If you do not receive confirmation kindly resubmit.

METHOD OF PAYMENT

TOTAL PAYMENT