Order Form

Print a copy of this order for your records before you submit it.

CUSTOM COATED SEED TRANSMITTAL

Customer Date P.O. Number
Name Phone Number Email



RAW SEED INFORMATION
Species Variety
Lot No. Seed Count
Treated Labeled Germ
Producer Qty. of Raw Seed









CONVENTIONALTREATMENTORGANIC PROCESSES
  FILM COAT
  GRO-COAT
  Pre-Prep
  Prep-Coat
  Prep-Coat Special
  Light Density
  Medium Density
  Medium Density-D
  Heavy Density
  Other
  Thiram
  ProGro
  Trigard
  FarMore
  F-300
  Fl-400
  Fl-500
  Organic-Onion
  FareMore Ol-100
  Other
  PULSE Gro-Coat
  PULSE Pre-Prep
  PULSE Pre-Coat
  D Pellet (brown)
  White Pellet
Film/blazer Color Belt Size AirMaxx (encrusted)



PACKAGING INSTRUCTIONS
No. of unit per package   Pack in Lbs
SDI Cartons SDI Pails Other





SPECIAL LABELING INSTRUCTIONS
1) 2) 3)



SHIPPING INSTRUCTIONS
Request Ship Date Via
Billing Acct #
Shipping Address
 
 









ADDITIONAL COMMENTS OR INSTRUCTIONS
Waive Suitability Testing