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GreenLightSalviaExtracts.com

Online Printable Order Form
For your convenience this is a form that allows you to type all your order information online before you print.
You may also cut and paste product names from the site.

ADDRESS:
GreenLight Salvia Extracts
MauiGreenDragon
7 Waipono Lane #101
Wailuku, HI  96793
MAKE CHECKS and MONEY ORDERS PAYABLE TO:
Ethnobotanicals and Extractions or David McGhee

IMPORTANT!: Salvialight.com requires that you read the DISCLAIMER before we can process any order unless you are ordering online with credit card. Once you have read the Disclaimer Form, future orders do not require this process. Click the Disclaimer link above to read the disclaimer in full.

Please sign here to indicate that you read and agree with the disclaimer_____________________________________________
 
Name:
Date:
Address:
City:  State:
Zip:
Email: Please include email if you would like confirmation of shipment.
Quantity (weight in gram/milligram liquid volume, or # of seeds)

Item Description (Botanical Name of Specimen Material, Seeds, or Full Name of Research Material )
Total Cost

of this quantity of this item
  
SUBTOTAL:
  
LESS ANY CREDIT:
 
Shipping is:
$6.00 for Priority Mail ( 2-3 days ) Not guaranteed but reliable.
Free Standard USPS Shipping: (averages out to 3-5 days)
SHIPPING:
MAKE CHECKS and MONEY ORDERS PAYABLE TO:
Ethnobotanicals and Extractions
TOTAL:

IMPORTANT: If item(s) temporarily unavailable, what do you prefer? (check one box):
1. Substitution (list choices on back of this order form)
2. Back Order (up to 6 weeks maximum, after that point we would issue refund)
  3. Refund if not in stock   4. Credit  to be subtracted from your next order (we will send a credit note).

Payment is accepted in three convenient ways:

  1. Order using Visa, Mastercard, Discover, or American Express credit or check cards ( check cards must have the Mastercard or Visa logo). Remember we need to ship to the SAME address as is on card.
  2. Mail us your payment in the form of a Money Order, Personal or Business Check or Cashier's Check
    MAKE CHECKS PAYABLE TO: Ethnobotanicals and Extractions or David McGhee    . Personal / business checks are accepted however we must wait for them to clear before we can ship your order, until you become an established customer. Money orders are therefore preferred for faster service.
  3. Send Cash (we suggest by registered mail only as we are not responsible for lost cash), In place of coins, round down to the nearest dollar if the total is not an even dollar amount.
_______________________________________________________________________________________

Credit Card Information Must Be Entered By Hand
( Ethnobotanicals and Extractions should appear on your credit card statement )

MASTER CARD VISA DISCOVER AMERICAN EXPRESS

Card number:

___________________ /___________________/ ____________________/__________________

Exp. Date:________ /________ (Please note: your card will be charged immediately to reserve your order )
NAME AS PRINTED ON CARD:
(MUST be same as 'Ship to': name) ______________________________________________

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