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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 special notice on the reverse of this page; 



then carefully check the plants desired in the lists fol- 

 lovving, and return the lists promptly in the accompanying 

 franked envelope. It will aid this Office in its distri- 

 bution work if each experimenter v/ill fill out the form 

 below, and make no other notes or requests on the check 

 lists themselves. 



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 follov/ing 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. 



Expr e s s Office, 



Are plants wanted for open ground culture? 



" " " " greenhouse? 



How much land have you available for experimental planting 

 and how much do you wish to devote to such planting? 



Is this land owned or leased by you?. 



