Order Blank 
For High Grade Tested Seeds 
WRITE YOUR ADDRESS PLAINLY AND IN FULL in 
the blanks below, and use another sheet for other matters you 
wish to write about. This enables us to FILL ORDERS 
RAPIDLY and correctly, and your inquiries will not be so 
apt to be overlooked. For full instructions about ordering, etc., 
see directions page 96 of catalog. 
D. V. BURRELL SEED GROWERS CO., Rocky Ford, Colo. 
Gentlemen: In accordance with terms of your Descriptive Catalog, 
Check how goods P lease forward to: 
- 19 - 
are to be sent: 
Date- 
Parcel 
Post 
□ 
Express £ 
Name- 
(First Name) 
(Middle Initial) 
(Last Name) 
Postoffice— 
Rural 
Route- 
Box 
-No.- 
-State- 
Flease give both your Route Number and Box Number if on a Rural Route 
Number . 
Cash . 
Stamps 
Check . 
Draft 
Refund . 
P. M. Order. 
E. M. Order. 
Total . 
Do Not Use This Space 
O.K.’d by 
Shipped via . 
Date rec'd . 
Date sent . 
Filled by . 
Checked by . 
Packed by .... 
Number packages 
Address -— —-——- 
1 / 
QUANTITY 
NAME VARIETY 
PRIC 
Dollars 
E 
Cents 
V 
Z 
z 
S 
§ 
O 
> 
-1 
CO 
CO 
l 
co 
zn 
—I 
£ 
H 
HA 
z 
IN 
w 
H 
w 
H 
HH 
Ph 
HH 
£ 
& 
H 
H 
O 
Z 
O 
Z 
O 
Q 
oa 
W 
SE 
< 
EA 
Ph 
PL 
—- jf 
. i ... 
- I " 
Amount carried forward other side: 
extra seeds for the names of those who grow gardens, see other side. 
