Name:

Address:

E-Mail:

Telephone No:

Fax:

Activity

Cut Flower Grower

Pot/Garden Plant Grower

Other - Please specify

Crop Interest

Alstroemeria

Freesia

Gypsophila

Solidago

Limonium

Liatris

Hypericum

Chrysanthemum

Carnation

Scale of Activity

Area of Heated Glass/Plastic 

Area of Cold            

Outdoor Growing Area