EmailMe Form - Pine Straw Order Form

Name
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Home Phone #:
### - ### - ####
Cell Phone #:
### - ### - ####
Email
*If you would like to be notified next year.
Number of Bales:
Total price of Pine Straw
$ Dollars . Cents
$5.50 x _____
Delivery Fee
$ Dollars . Cents
Free delivery for order of 5 bales of pine straw within 10 miles of the church. Other deliveries are $10.
TOTAL:
$ Dollars . Cents
Total amount (Pine Straw Price + Delivery Fee)
Questions