1.Choose Tea Base: 2.

Choose Type : Teabagged / Loose Tea

Black / Oolong / Green / Rooibos Teabag quantity:___________

3. Select 2-4 Ingredients (circle) :

German Local Harvest: Strawberry, blackberry, currant, raspberry, apple, cherry, peach, plum, locust berry, pear, pumpkin,
apricot.
Ingredients: Almond, amaretto, anise, banana, blueberry, caramel, cinnamon, chai, chestnuts, chocolate, cider, coconut,
cranberry, grapefruit, ginger, hazelnut, honey, lemon, mango, maple, mocha, nutmeg, orange, passion fruit, pecan, peppermint,
pineapple, pomegranate, spice mix, vanilla.
Herb: Basil leaves, black peppercorn, burdock root, catnip, chamomile, cloves, cramp bark, dandelion leaves, dandelion root,
echinacea, elderberry, eleuthero root, eucalyptus, gentian root, ginger root, ginkgo, ginseng powder, hibiscus, jasmine flower,
juniper berry, lavender, lemon balm, lemongrass, lemon verbena, licorice root, linden leaves, linden flower, lycii berry, maca
powder, nettle leaves, raspberry leaves, rose petals, rose hips, sage, spearmint, stevia, and valerian.

4. Custom Label (optional) : _____________________________________________________________

Tea Base Rewrite 2-4 circled Type bagged or loose Number of teabags 12 / 28 / Qty. Cost: 12=$17
ingredients 40 28 = $32 40=$40
Loose=$30

Total Cost: __________

_________________________________________________________________________________________
_________________________________________________________________________________________

Name:_______________________ Address:______________________________ Date: ____________

DD/MM/YYYY
Signature: ______________________ Phone Number: _______________________

Email: __________________________________ City: ______________________ Country: ________________

USA CANADA OR GERMANY

Credit Card (Circle One): VISA M/C American Express DKB Master Card

Credit Card Number: / / / EXP Date: / 3-4 digit code on back: _____