4947 Foxbriar Trail
Charlotte, NC 28269 USA
Tel.
704-597-7789   Fax 704-509-1845
e-mail
batcha_seeds@bellsouth.net  ~ website www.seedquest.org/spi
a 501(c)(3) organization

REQUEST FOR SEED

1. Print name, address, telephone, fax, e-mail of organization requesting seed.

____________________________________________________________________________________

____________________________________________________________________________________

2. Number of Packets requested.__________________________.

3. An assortment of seed is provided from the following - garden bean, beet, broccoli, Brussels sprouts, cabbage, cantaloupe, carrot, Chinese cabbage, lettuce, mustard, onion, peas, pepper,  radish, spinach, squash, tomato, watermelon plus others and some flowers. NOT ALL OF THESE SEEDS ARE AVAILABLE AT ALL TIMES. 

4. Date to ship seed_____________________________________.

5. Print name, address, telephone, fax, e-mail of  the PERSON and ORGANIZATION  where seed is to  be shipped. This information will be listed on any needed import documents.   

____________________________________________________________________________________

____________________________________________________________________________________

__________________________________________________________________________________________________

 6. List organizations that will participate in the program. _____________________________________

____________________________________________________________________________________

____________________________________________________________________________________

 7. Seed cost is: 0 - 20,000 packets = $.17 per packet; 20,001 - 50,000 packets = $.16 per packet; 50,001 - 100,000 packets = $.14 per packet; over 100,001 packets = $.12 per packet. Payment of 1/2 is due with request and balance is due after packaging and  before shipment is made. Shipping cost from New York State is additional. COST IS SUBJECT TO CHANGE.

8. A written report will be prepared on use of the seed within nine months of shipment.

9. SEED WILL NOT BE SOLD AT A PROFIT WHETHER DIRECTLY OR INDIRECTLY.

Total number of packets____________.  Price per packet $_________.  

Total $_________________.
 

___________________    ____________________    __________________  __________________
Signature                               Print Name                               Title                                   Date