AOSCA Refuge in a Bag After filling in the appropriate fields below, print this page for your records before clicking the "submit" button. If you have not received confirmation within 24 hours, please contact Illinois Crop at 217-359-4053. When calling, please specify the type of request you initiated (Tag Order, Certificate Order, Contact Us). If you have questions, please contact: Illinois Crop Improvement Association Tags & Records Attn: Diane Campbell Phone 217-359-4053 Fax 217-359-4075 e-mail: dcampbell@ilcrop.com Name of person placing order Invalid Input Email* Please let us know your email address. Phone Invalid Input Company* Invalid Input Location* Invalid Input RIB Variety* Invalid Input Primary Variety* Invalid Input Secondary Variety* Invalid Input Crop* Invalid Input Class* Invalid Input Primary Variety Year & Location Grown:* Invalid Input Secondary Variety Year & Location Grown:* Invalid Input Interagency Invalid Input Primary Variety Sheller Test # Invalid Input Secondary Variety Sheller Test # Invalid Input Producer or conditioner # Invalid Input Lot#* Invalid Input Number of Tags* Invalid Input Net weight per bag/container* Invalid Input Total weight of tag order (lbs)* Invalid Input Seed Count* YesNoInvalid Input Seed/Pound (if Yes enter value here) Invalid Input Tag Type* OneTwoInvalid Input Tag System 1 tag system lists the purity and germ as well as the variety, lot & producer/based on a clean sample within 1 year Pure Seed Invalid Input Crop Seed Invalid Input Inert Invalid Input Weed Invalid Input Germination Invalid Input Security Code* RefreshInvalid Input