New Customer Form

Check each box next to the desired service(s).

1.

2.

Select each desired strain and size

Capsules

Select Strain

Red Thai

Red Malay

Red Sumatra

Red Bali

Red Maeng da

White Borneo

White Indo

White Maeng da

Green Malay

Green Indo

Maeng Da

Ultra Indo

Ultra Bali

Bentuangie

Select Size(s)

Red Thai Cap Size
Red Malay cap size
Red Sumatra cap size
Red Bali cap size
Red Maeng da cap size
White Borneo cap size
White Indo cap size
White Maeng da cap size
Green Malay cap size
Green Indo cap size
Maeng da Cap size
Ultra Indo cap size
Ultra Bali cap size
Bentuangie cap size
Powder

Select Strain

Red Thai

Red Indo

Red Sumatra

Red Bali

Red Maeng da

White Indo

White Bali

White Sumatra

White Borneo

White Maeng da

Green Thai

Green Indo

Green Malay

Green Bali

Ultra Bali

Bentuangie

Ultra Borneo

Ultra Indo

Ultra Malay

Ultra Sumatra

Ultra Maeng da

Select Size(s)

Red Thai Powder size
Red Indo Powder size
Red Sumatra Powder size
Red Bali Powder size
Red Maeng Powder size
White Indo powder size
White Bali Power size
White Sumatra powder size
White Borneo Powder Size
White Maeng da Powder Size
Green Thai Powder size
Green Indo Powder size
Green Malay Powder size
Green bali powder size
Ultra Bali Powder Size
Bentuangie Powder Size
Ultra Borneo Powder Size
Ultra Indo Powder Size
Ultra Malay Powder Size
Ultra Sumatra Powder Size
Ultra Maeng da Powder Size

Quantity

Quantity

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