Signature:

Quantity (weight in grams/ liquid volume,or # of seeds)	Item Description Botanical Name of Specimen Material, Seeds, or Full Name of Research Material	Total Cost of this quantity of this item
	SUBTOTAL:
	LESS ANY CREDIT:
	SHIPPING ($5.99 for airmail for most orders):
	TOTAL:

If item(s) temporarily unavailable, do you prefer (check one box):

1. Substitution (list choices on back of this order form)	2. Back Order (up to 6 weeks maximum, after that point we would issue refund)
3. Refund if not in stock or due to arrive soon (company check made out to the customer's name)	4. Credit to be subtracted from your next order (we will send a credit note).

_{SHIPPING PRICES for Airmail: Up to 250 grams: $5.99 ; Between 250-500 grams: $10.00 ; Between 500-1000 grams: $20.00 ; Between 1000-1500 grams: $25.00 ; Between 1500-2500 grams: $30.00 ; Up to 3150 grams: $35.00 ; Up to 3600 grams: $40.00 ; Up to 4500 grams: $45.00 ; Over 4500 grams: Inquire for costs.}

_{SHIPPING INFO for all INTERNATIONAL clients}: _{We ship Airmail, and packages can reach your country in 4-15 days, although occasionally airmail takes up to 30 days in rare instances. If you wish to receive your order faster, you can write Global Express on your order and we will ship by Global Express (2-4 days), for which you will be charged at cost.}

_{Payment is accepted in four convenient ways:}

_{(1) Order using your Visa or Mastercard by mailing this order form including your card details.}

_{(2) Mail your order to us with an International Money Order in US Dollars (made out to Pure Land).}

_{(3) Mail your order to us with U.S. currency (we recommend registered airmail letter for this - we cannot be responsible for lost currency).}

_{(4) Inquire for our banking details and make a wire transfer into our bank account (for orders of $ 500 USD or more).}

_{Credit Card Information Must Be Entered By Hand for security reasons}

MASTER CARD VISA DISCOVER AMERICAN EXPRESS Card number: ________ /________/ ________ /________ Exp. Date:________ /________ (Please note: your card will be charged immediately to reserve your order) NAME AS PRINTED ON CARD: (MUST be same as 'Ship to': name) ______________________________________________

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