Desired shipping date:

Foreign requests include customs and agricultural instructions for your country here:

1. I agree not to sell the seeds provided
2. I agree to all provisions of the Material Transfer Agreement enclosed (if required).

Signature

Name (printed)

Address

Email

Please send me:		Check to request	Lot # (for our use)
Hybrids of unknown parentage
	Tropical day blooming	_________	_________
	Tropical night blooming	_________	_________
	Tropical day blooming Anecphya (difficult)	Not yet available	_________
	Hardy	Not yet available	_________
Species - recommended for experienced growers
	Select from list	_________	_________
	Species with provenance (select from list - MTA required)	Not yet available	_________

Within the US enclose this form, a small self-addressed padded envelope with postage equal to the amount required to send it, and a properly executed Material Transfer Agreement (MTA) if required. Please do not send cash, checks or metered postage.

Outside the US, enclose the form(s), a small self-addressed padded envelope, a money order in US$ for return postage and any expenses of meeting the requirements of your country (i.e. Phyto-Sanitary Certificate). It is the responsibility of the recipient to provide us with your country's Customs and Agricultural requirements. Enclose a properly executed Material Transfer Agreement (MTA) if required.

Requests with incomplete information or inadequate postage will be discarded.