Deck the Halls for Hospice

Order Form

* = required

Purchase Items
I would like to purchase the following item(s):
Wreath: $50 x =
Planter: $65 x =
Poinsettia (Red): $23 x =
Poinsettia (Pink): $23 x =
Poinsettia (White): $23 x =
Swag: $40 x =
Gift Card ($20 Value): $20 x =
Gift Card ($50 Value): $50 x =
My Contact Information
Name:
Address:
City:
Province:
Postal Code:
Phone Number:
Email Address:
Gift Recipient Information (optional)
If this order is a gift, please complete the following information.
Gift Recipient Name:
Address:
City:
Province:
Postal Code:
Phone Number:
Pick-up or Delivery
Please select one of the options below.
 

I will pick up my order at Lacoste Garden Centre located at 2787 St. Mary's Road on Saturday, November 30, 2024.

 

Please deliver my order to the address that I provided above on Saturday, November 30, 2024.