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Seed Request
QLE Seed Request
Type of Request
*
New Seed Request
Additional Seed Request
Replant Seed Request
Name of Grower
*
First
Last
Phone
Text Message Agreement
*
Yes, I want to receive text messages at the number above.
No, I do not want to receive text messages from QLE.
Email
*
Crop
*
Corn
Soybeans
Wheat
Hybrid Variety
Delivery Location
*
Take it to my farm
Bring it to my field
Field Location for Delivery
Field Location for Replant
Photo or Video Uploads
Drop files here or
Additional Information
Agreement
*
I consent to having QLE Seed and this website store my submitted information so they can respond to my seed request via my preferred communication preferences.
I agree
*
Comments
This field is for validation purposes and should be left unchanged.
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