Easter Plant Order Form
04/20/2025 | Please complete this form and click submit to order your Easter flowers.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Tulips
Please select all that apply.
6 inch ($15 each)
8 inch ($25 each)
Yellow
Pink
Lavender
Hyacinths
Please select all that apply.
6 inch ($15 each)
8 inch ($25 each)
Pink
Blue
White
Daffodils
Please select all that apply.
6 inch ($15 each)
Lilies
Please select all that apply.
Single Stem ($20 each)
Double Stem ($30 each)
Donation to offset cost of Easter decorations
Select One:
*
Please select one option.
In Honor Of
In Memory Of
In Thanksgiving For
Notes to be Printed in the Easter Bulletin
*
Total Number of Plants
*
Please select one option.
1
2
3
4
5
Select Option
1
2
3
4
5
Total Cost
Payment
6 inch Pot ($15.00)
8 inch Pot ($25.00)
Single Stem Lilies ($20.00)
Double Stem Lilies ($30.00)
2 - 6 inch Pots ($30.00)
2 - 8 inch Pots ($50.00)
2 - Single Stem Lilies ($40.00)
2 - Double Stem Lilies ($60.00)
6 inch Pot ($15.00)
8 inch Pot ($25.00)
Single Stem Lilies ($20.00)
Double Stem Lilies ($30.00)
2 - 6 inch Pots ($30.00)
2 - 8 inch Pots ($50.00)
2 - Single Stem Lilies ($40.00)
2 - Double Stem Lilies ($60.00)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
04/20/2025
Please complete this form and click submit to order your Easter flowers.
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