ORDER FORM

BIOCONTROL NETWORK --- Tel. (615) 370-4301 --- Fax. (615) 370-0662
5116 Williamsburg Road Brentwood, TN 37027-5113

===============   BILLING ADDRESS  ===============    ===============   SHIPPING ADDRESS   ==============

NAME: ____________________________________________    NAME: _____________________________________________

BUSINESS NAME:____________________________________    BUSINESS NAME:_____________________________________

ADDRESS:__________________________________________    ADDRESS:___________________________________________

CITY: ____________________________________________    CITY: _____________________________________________

STATE: __________________ ZIP: ___________________    STATE: __________________ ZIP: ____________________

HOME PHONE: (______) _____________________________    BUS. PHONE: (______) ______________________________   

EMAIL: __________________________________________________________________________________________________

=========================================  METHOD OF PAYMENT  ===========================================

           _____ CHECK   _____ VISA   _____ MASTERCARD   _____ AMERICAN EXPRESS   _____ DISCOVER

CARD NUMBER: ________________________________________________  EXP. DATE: ______________   CCV: _________ 

SIGNATURE: ______________________________________________________________________________________________
 ________________________________________________________________________________________________________
| Item# |                        Description               | Qty | Unit | Wt. | Unit Price | Total Price |
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|
|       |                                                  |     |      |     |            |             |
|_______|__________________________________________________|_____|______|_____|____________|_____________|

__________________________________________________________________________________________________________
                                                                                    
 SHIPPING METHOD:    ___ UPS GROUND     ___ FedEx GROUND                          SUBTOTAL   ____________
                                                                            
 ___ PRIORITY MAIL   ___ UPS 2nd DAY    ___ FedEx 2nd DAY               TN 9.25% SALES TAX   ____________
                                                                                     
 CHECK SHIPPING      ___ UPS OVERNIGHT  ___ FedEx OVERNIGHT                       SHIPPING   ____________
 TABLES FOR RATE                                                       
 CALCULATION OR ASK        ORDERS UNDER $20.00 ARE SUBJECT             PROCESSING FEE   ____________
 A CONSULTANT FOR             TO A $1.95 PROCESSING FEE                                                            
 ASSISTANCE                                                                          TOTAL   ____________     
__________________________________________________________________________________________________________

  1. Biocontrol Network ships all live insects via Next Day or Second Day Air. During the hottest months of summer, it
    may be necessary to use Overnight Service to insure timely delivery.
  2. For mixed orders (including both beneficials and other products) you will receive 2 shipments. Please use
    appropriate rates to estimate your shipping costs or call Biocontrol Network for assistance.
  3. Mixed orders of multiple species of beneficials, in most cases, will be shipped separately. Whenever possible we
    will combine and ship together to reduce shipping costs.
  4. For Alaska, Hawaii and overseas shipments, call for shipping charges.