Order Request
After you fill out this order request, we will contact you to go over details and availability before the order is completed. 
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What is the item you would like to order? *
J$5 Small-
$10 Medium-
$15 Large-
Please buy one for your love one and 1 for a senior citizen. We will deliver your gift to the local nursing home.
All proceeds to go towards student activities and support.

Your name *
Phone number *
Preferred contact method *
Send to: *
Allergies Free Basket (Select all that applies) *
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