Easter Flower Order Form
2021
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
In Memory Of:
In Honor Of:
Please:
I will pick up my plants after the 11:30 a.m. worship on Easter morning.
Please take my plant(s) to a shut-in after Easter worship.
Flower Choices
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Easter Lilies
$
10.00
Each plant will have 5-6 blooms.
Quantity
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10
Tulips
$
10.00
Each plant will be a single color. Colors vary.
Quantity
0
1
2
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5
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8
9
10
Daffodils
$
10.00
Quantity
0
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2
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8
9
10
Hyacinth
$
10.00
Quantity
0
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10
Mum Plant
$
12.00
Quantity
0
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10
Processing Fee
$
1.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
SUBMIT
Should be Empty: