Mesa Garden / PO Box 72 / Belen, NM 87002 USA / Phone: 505-864-3131

Order blank to be used by domestic customers. Fax: 877-248-2664 email: cactus@swcp.com

Name: _________________________________ Order Date: ____________________________

Address: _______________________________ Your Tel # : ____________________________

_______________________________ Your Fax #: ____________________________

_______________________________ email: ______________________________

-------Seeds-------------

Catalog number pkt 100 500 Price Plants Species Name (optional, if we have a ? )

In 2005 we will not mail paper printed catalogs. Reply with problems this would cause, so we can help

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Credit card number __________________________ Expire date: ______ Signature: _____________________

CV (Security) No __________________________

Subtotal of all seeds ………………………………………………………………. $ ___________

Subtotal of all plants ………………………………………………………………. $ ___________

Total plants and seeds ……………………………………………………………………… $ ____________________

Discount for large order: >$100 -4%, >$250 -6%, >$500 -8%, >$1000 -10% ____________________

Previous [credit/balance due] from prior order ……………………………………………. $ ____________________

Postage (seeds only) $2.50; >$200=$5.00; >$300=$7.00 >$500=$9.00………… $ ____________________

Postage: plants and seeds-surface (15% of plant value, min. of $5.50, .... $ ____________________

              plants and seeds-air (15% of plant value, min. of $5.50., .) ...........….. $ ____________________

NM residents add 6% tax ………………………………………………...…...…… $ ____________________

Order total in US$ ………………………………………………………………...…...….. $ ____________________

Catalog number pkt 100 500 Price Plants Species Name (optional, if we have a ? )

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Use ordinary paper for addition room, all fees charged are based on rates used in current catalog. There

are no regulations regarding shipping CITES App. 1 seeds or plants within the US. All necessary permits

are on file here for interstate commerce in US endangered species.