Seed Catalog - Fred C. Gloeckner & Company Inc.

2012-2013 Order Form
Fax Orders 24/7 to: Seed Division - 914-698-2857, International Division - 914-698-2840
Mail Orders to: Fred C. Glocekner & Co., Inc., 600 Mamaroneck Ave., Harrison, NY 10528 USA
Please refer to page 1 for all phone, and online ordering information. Hablamos Español.
Customer Information (Please Print)
Order Date:______________________________________________________ Requested Ship Date:_______________________________________________
Customer PO #:__________________________________________________ Account #:__________________________________________________________
Business Name:__________________________________________________ Contact Name:______________________________________________________
Bill to Address
Street:___________________________________________________________ City:________________________________________________________________
State:__________________________ Zip Code:_______________________ Email:______________________________________________________________
Phone:___________________________________________________________ Cell Phone:_ ________________________________________________________
Ship to Address (If different than above)
Street:___________________________________________________________ City:________________________________________________________________
State:__________________________ Zip Code:_______________________
Preferred Shipping Method
Ground _______ 2nd Day _______ Next Day _______ Other _______
Shipping charges will be added to all seed orders.
To avoid delay, when necessary, may we substitute similar varieties? Yes _______ No _______
2012-2013 Seed Order (Continue on page 126 if necessary)
Item Number Description Quantity Price/1000 sds Total
See reverse side for payment information.
New! Order Seeds Online at www.fredgloeckner.com or Call 800.345.3787
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