Rotary Roses Form

Rotary Roses Form

Please submit a separate form for each recipient/delivery address
Rotary Thanksgiving Roses 2021
Rose Buyer Name *

First Name Last Name
Rose Buyer Email *
example@example.com
Rose Buyer Phone Number *
Please enter a valid phone number.
Who is your Rotary Contact: *
The name of the person we are delivering the roses to: *

First Name Last Name
The person's phone number. *
Please enter a valid phone number.
Delivery address *

Street Address

Street Address Line 2

City
The message to go on the roses. (Optional)

0/40
The number of dozen roses to be sent: *

1 dozen 2 dozen 3 dozen 4 dozen 5 dozen 6 dozen Other
Total cost of the order (there is no HST, the value below is the total cost):
Choose a delivery date: *

Kitchener / Waterloo - Tuesday October 5th Cambridge - Wednesday October 6th Guelph / Ayr - Thursday October 7th
Any additional notes? Please note, specific delivery times or colour requests will be attempted, but not guaranteed.
You can pay by Etransfer cheque or credit card. The cost per dozen is $40.

Your order will cost {totalCost37}. There is no HST.

Etransfer with most major banks to: phrotaryfinance@gmail.com In the notes section of the etransfer please put your last name and order number {uniqueId}.

If paying by cheque, make cheques payable to "Rotary Club of Cambridge (P-H)" and deliver to your Rotary contact or mail to Todd Lyons at 293 Grand Ridge Drive Cambridge ON, N1S 4W9.
You can pay by Etransfer, cheque or credit card. The cost per dozen is $40. *

Etransfer Cheque Credit Card

Should be Empty:

Rotary Roses Form

Rotary Thanksgiving Roses 2021

Credit Card