Poinsettia Order Form 2021

Please fill out this form and click submit. Flowers may be picked up following the Christmas Eve Service.
Deadline for orders is Sunday, December 5th.

Name

*

Email

*

This address will receive a confirmation email

In memory of

In honor of

Presented by

*

White Poinsettias

None (0) 1 White ($6.48) 2 White ($12.97) 3 White ($19.45) 4 White ($25.93)

Amount

Red Poinsettias

None (0) 1 Red ($6.48) 2 Red ($12.97) 3 Red ($19.45) 4 Red ($25.93)

Amount

Jinge Bell Poinsettias

None (0) 1 Jingle Bell ($6.48) 2 Jingle Bell ($12.97) 3 Jingle Bell ($19.45) 4 Jingle Bell ($25.93)

Amount

Transaction Fee .30

Select One:

*

Please select all that apply.

Pick up after service Deliver to sick or homebound

Online orders include a 2.9% fee.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit. Flowers may be picked up following the Christmas Eve Service.
Deadline for orders is Sunday, December 5th.

Please Fix the Following

Close