House Plant Delivery Form
Plants
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( X )
Succulent
$8.00
$
8.00
Quantity
0
1
2
3
4
5
Â
Â
String of Pearls
$6.00
$
6.00
Quantity
0
1
2
3
4
5
Â
Â
Snake Plant
$6.00
$
6.00
Quantity
0
1
2
3
4
5
Â
Â
Rubber Plant
$8.00
$
8.00
Quantity
0
1
2
3
4
5
Â
Â
Peace Lily
$10.00
$
10.00
Quantity
0
1
2
3
4
5
Â
Â
Potting Soil
$5.00
$
5.00
Quantity
0
1
2
3
4
5
Â
Â
Name
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Delivery Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payment Methods
Debit or Credit Card
1
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: