POINSETTIA ORDER FORM 2015 $12 EACH PLEASE FAX ...
DISTRICT # ______________
POINSETTIA ORDER FORM 2015 NAME __________________________________________________________
ADDRESS _________________________________________________________ PHONE __________________________________________________________
RED
_____________
PINK ____________
WHITE _____________
MARBLE __________
YOUR PICK UP DATE _______________________________ (When you would like to pick them up) PICK UP AT 551 N KING AVENUE NO PICK UPS ON SATURDAY/SUNDAY
$12 EACH PLEASE FAX FORM TO LORI HIMMEL (IMPD) 317-327-6490 PLANTS WILL BE AVAILABLE DECEMBER 1st WHILE SUPPLIES LAST! ALL PROCEEDS GO TO THE IMPD CLOTHE A CHILD PROGRAM CASH OR CHECK MADE PAYABLE TO CLOTHE A CHILD
POINSETTIA ORDER FORM 2015 NAME __________________________________________________________
ADDRESS _________________________________________________________ PHONE __________________________________________________________
RED
_____________
PINK ____________
WHITE _____________
MARBLE __________
YOUR PICK UP DATE _______________________________ (When you would like to pick them up) PICK UP AT 551 N KING AVENUE NO PICK UPS ON SATURDAY/SUNDAY
$12 EACH PLEASE FAX FORM TO LORI HIMMEL (IMPD) 317-327-6490 PLANTS WILL BE AVAILABLE DECEMBER 1st WHILE SUPPLIES LAST! ALL PROCEEDS GO TO THE IMPD CLOTHE A CHILD PROGRAM CASH OR CHECK MADE PAYABLE TO CLOTHE A CHILD
