State Form 46766 - Tree Seedling Order Form For Fall '00/spring '01

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State Form 46766 (R2 /6-00)

Tree Seedling Order Form for Fall ‘00/Spring ‘01

IDNR, Division of Forestry State Tree Seeding Nurseries

IMPORTANT INFORMATION REGARDING CENTRALIZED ORDERING: You may choose the nursery from where you

receive your seedlings. All orders must be submitted to Vallonia State Nursery for processing. Do not send payment. You will be

invoiced.

Please print or type

UPS Ship to (NO P.O. BOXES):

First and last name: ____________________________

Name: __________________________________________

Address :_____________________________________

Address:________________________________________

City: _______________ State _____ ZIP__ ________

City: _________________ State _____ ZIP___________

Day/Evening Phone:________________________________

*UPS rate is $8/100 seedlings.

County where planted:______________________________

**UPS cannot ship to a P.O. Box.

Tax Exempt #:______________________________________

*** Arrival dates cannot be guaranteed.

Choose ONE source location for pickup (Jasper-Pulaski or Vallonia):_______________________________________________

Circle one:

Pickup

UPS

If pickup, circle one:

Buyer

County Agent

Forestry Consultant

Forestry Consultant or County Agent Name:_____________________________________

1st

2nd

3rd

4th

1st

2nd

3rd

4th

1st

2nd

3rd

4th

Qty

Choice

Code

This form may be copied if additional space is needed.

Buyer Agreement:

I agree to plant these seedlings in Indiana for conservation plantings as stated in the Nursery Section mission. Plant materials will not be redistrib-

uted or resold for profit. If seedlings produced by the nurseries are to be given away, I agree to conduct an educational program stating the Nursery

Section mission prior to seeding giveaway. I agree that I will not submit duplicate orders for the purpose of gaining advantage in the

lottery. I have read and agree to the conditions as stated above.

BUYER SIGNATURE:________________________________

Fill out the order from completely and mail to: Vallonia State Nursery, P.O. Box 218. Vallonia, IN 47281

Fall 2000/Spring 2001 Tree Seedling Order Form Page 7