U.S. Order Form

Due to high demand, there can be a shipping delay of 2-3 weeks for Dairy and Water Kefir grains.

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GEM Cultures, Inc. PO Box 39426 Lakewood, WA 98496, USA		Date:
Name
Shipping Address:	Please provide the street address or PO Box, wherever you receive USPS 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:
Notes: 1.	Extreme Heat or Freeze will cause shipping delays for Fresh Cultures, as these are LIVE Cultures. (See Home Page)
2.	Due to High Demand there can be shipping delays of 2-3 weeks for Dairy and Water Kefir Grains.
Quantity	Description (variety, size, weight)	Item Price	Total Cost








		Subtotal:
Shipping FRESH:	Any orders that include Kefir, Viili, Fil Mjölk, Seed Miso, Kombucha, Sourdough, Cool Rise or Cultured Crepe add $12.00 shipping. See directions at: U.S. Orders	Shipping: $12.00 (Covers Fresh and Dry goods in the order.)
Shipping DRY GOODS ONLY:	Orders that do not include Fresh Cultures use chart below: $0 to $5.00..............$3.00 $36.01 to $44.00.....$8.00 $5.01 to $10.00.......$4.00 $44.01 to $52.00.....$9.00 $10.01 to $20.00.....$5.00 $52.01 to $60.00.....$10.00 $20.01 to $28.00.....$6.00 $60.01 to $70.00.....$11.00 $28.01 to $36.00.....$7.00 $70.01 and over.....$12.00	Shipping: (Dry Goods)
Payment:	Send Check or Money Order, with written order to: GEM Cultures, Inc. PO Box 39426, Lakewood, WA 98496	ORDER TOTAL: