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To be checked and returned to the Office of Foreign Seed 

 and Plant Introduction, Department of Agriculture, 



Washington, D. C. 



Please read the statement on the reverse of this page; 



then carefully check the plants desired In the list fol- 

 lowing, and return It promptly in the accompanying franked 

 envelope. It will aid this Off Ice In Its distribution work 

 If each experimenter will fill out the form below, and 

 make no other notes or requests on the check list itself. 



Give here your permanent address for letters: 



Name of experimenter: 

 P. 0. Box, 

 R. F. D. No. , 

 Street and No., 



Post Office, S t a t e , . 



Do you wish plant material sent to the above address? 



If not, fill out the following mail address for plant ma- 

 terial . 

 Name of person who will receive plants, 



P. 0. Box. 



R. F. D. No. , 



Street and No . , _. 



Post Office, „ State , 



Are you willing to pay expressage on the plants which you 



request? If so, give the Express Office to which 



you wish the plants shipped. 



Express Office, _... 



