POINSETTIAS ORDER FORM
Cost per poinsettia $13.00. Contact Alfreda Smith (252) 883-5264 or Donald Ford (252) 673-3998. Please note date and time for pickup. Poinsettias are located at Northwest Halifax High School 8492 Highway 48, Littleton, NC 27850
Email address *
FIRST & LAST NAME *
Your answer
CONTACT INFORMATION *
Your answer
COLOR & QUANTITY
RED
PINK
WHITE
1
2
3
4
5
6
7
8
9
10
More than 10, enter color and amount below.
Your answer
Questions or Comments
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Halifax County Schools. Report Abuse