2016-2017 Balloon Order Form
Place an order to have balloons with a special treat delivered to a Xavier High School student for birthdays or special occasions!
Delivery Date
Order must be received at least 2 days prior to delivery date.
MM
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DD
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Name of Student (First and Last Name)
Your answer
Grade of Student
Balloon Bouquet Packages
Please select the balloon package you would like. Order must be placed and payed at least 2 days prior to delivery date. Payment MUST be sent to Xavier business office/attendance office. Cash and checks are acceptable. (*Checks should be written out to Xavier Catholic Schools)
Occasion
Mylar Balloon Saying and Appearance
Email address of person ordering the balloon bouquet
You will receive an email to verify that we have received the order
Your answer
Message you would like on the gift tag
Your answer
Payment you will send to Xavier business/attendance office
MUST arrive at least 2 days before the scheduled delivery and should be in an envelope with "Balloon Order" written on the outside of the envelope and the student's name in the memo of the check or on the envelope.
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