DCPA Valentine’s Day Grams- Order Form
Please complete the form with all information. Contact Lyndsay Hill via email at lyndsayhill86@gmail.com with questions. Please note pick up address & important dates below. Please verify your order with DCPA to ensure we receive your payment!
Purchased By Name/Firm Name
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Valentines Day Gram Information
To:
*
From:
*
Message:
*
Valentine’s Gram Orders. Check box in top left corner and select quantity.
*
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Pick Up
Please choice quantity for pick up at Hayes Berry White & Vanzant
$
7.00
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Item subtotal:
$
0.00
Delivery within Denton City Limits
Please indicate address(es) below.
$
8.00
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Item subtotal:
$
0.00
List delivery address(es) here.
Please be specific and number address(es) if there are more than 1
Payment information
*
Cash
Check
AffiniPay QR Code (below)
Please provide AffiniPay Code
Submit
Should be Empty: