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Note:  If you are unable to Print this order form, please include, on a piece of paper, all of your contact information requested on the form with a list of the items you would like. Send it, with your check or money order, to the address on the form. Thank you!

 

Click here for Printer Friendly Order Form: PDF Format 

GEM Cultures, Inc.
PO Box 39426                             To use PayPal, email us at:
Lakewood, WA 98496, USA           gemculture@juno.com

Date:

Name

  
Shipping Address: Please provide the street address or PO Box, wherever you receive your mail.  For orders including Fresh Cultures, provide phone number or e-mail address so we can tell you when to expect your order.

Address:

  

City:

  

State

                                                Zip:

Phone:

                                                                  Email:

Please Note:

 Extreme Heat or Freeze will cause shipping delays for Fresh Cultures, as these are LIVE Cultures. (See Home Page)

Please  Include:    

Koji variety and size:  Light, Red, Barley, Soy or Shoyu Kit 15g or Commercial 40g or 60g.  Natto size: Kit 11g or Commercial 3g (pure spore). Super Sealer Lid size:  Standard or Wide Mouth.
Quantity Description (Include: Variety, Size, Weight) Item Price Total Cost
       
       
       
       
       
       
       
       
 

 

    
 

 Merchandise Total

    
Shipping FRESH: Cultures shipped with Cold Ice Pack : Any order with 1 or more of these cultures: Kefir, Viili, Fil Mjölk, Seed Miso, Kombucha, Sourdough, Cool Rise or Cultured Crepe add $16.00 shipping.  See directions at: U.S. Orders Shipping: $16.00  (Covers all items in the order.)  
Shipping DRY GOODS ONLY:

Orders that do not include Fresh Cultures use chart below.

(These are shipped by either First Class or Priority mail.)

$0 to $10.00............$6.00                     $70.01 to $80.00.....$13.00

$10.01 to $20.00.....$7.00                     $80.01 to $90.00.....$14.00

$20.01 to $30.00.....$8.00                     $90.01 to $100.00.....$15.00

$30.01 to $40.00.....$9.00                     $100.01 to $110.00....$16.00

$40.01 to $50.00.....$10.00                   $110.01 to $120.00....$17.00

$50.01 to $60.00.....$11.00                   $120.01 to $130.00....$18.00

$60.01 to $70.00.....$12.00                   $130.01 and up.........$19.00

 Shipping  
Payment: 

For Pay Pal, email gemculture@juno.com or

Send Check or Money Order, with written order to:

GEM Cultures, Inc. PO Box 39426, Lakewood, WA 98496 

 ORDER TOTAL:  

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