2022 EMRC Poinsettia Sale Order Form

2022 Poinsettia Sale Online Order Form

Orders Due November 9th Proceeds benefit End Polio Now
Buyer's Information
Name

Buyer's Full NameRotarian Name
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Person Picking Up Order: Dec 7th at Flowers of Edina, 7029 Amundson Ave, 9-11 AM

Full Name

Your Order

Small RED

One red poinsettia in a pot

$16.00 Quantity

Large RED

Three red poinsettias in one pot

$27.00 Quantity

Small WHITE

One white poinsettia in a pot

$16.00 Quantity

Lage WHITE

Three white poinsettias in one pot

$27.00 Quantity

Delivery

Can't pick up your order? We deliver!

$25.00

Additional Donation

Enter the amount of your donation.

$1.00 Donation Amount

Total

$0.00

2022 Poinsettia Sale Online Order Form