Professional Documents
Culture Documents
Name: ___________________________________________________
Address: _________________________________________________
City: __________________________ State: ______ Zip: __________
________Check here if this is a change of address. List old Zip Code_____________
SUBSTITUTIONS: Please indicate if we may substitute: Yes or No
Occasionally we run out of a particular variety. We will only substitute with a very similar variety.
DO NOT ORDER SWEET POTATOES OR POULTRY ON THIS FORM
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Merchandise
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Veg. Type
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Cost/Each
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Total Cost
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[Please remit separate payment (check or money order only) for sweet potatoes and seeds.)