Your alias 

____________________________________

Address 

____________________________________

City, State, Country 

____________________________________

Postal code 

____________________________________

Your email address 

____________________________________


* Mail this form along
with your payment to:

DUTCHSEEDSBANK
Postbus 56722
1040 AS
Amsterdam
(Holland)


Breeder Variety Price Per Pack Number of Packs Total Cost
example:
Sample Seed Co. 		example:
Powerplant		 example:
€ 10 		example:
2 		example:
€20
         
         
         
         
         
         
         
         
  Subtotal  
  Discount  
Add shipping (5€) for each 4 packs.
(1 to 4 = 5€, or 5 to 8 =10€) 		Shipping  
Total Cost  

Orders can be sent by: Post (see address above) Email: Info@dutchseedsbank.com
Freebie Request  
Payment Sent, Amount / Method  

* Please double-check your order to ensure that you have printed all information clearly, and that you have included your email address. We're sorry, but we cannot respond to any order enquiries that do not have a legible email address included with the order.

We cannot predict stock at the time your order arrives, so if you prefer not to wait on back order if any item(s) are out of stock when we receive your order, you may include replacement choice(s) on the back of this form.