Pine Needle Order Form

March 16 - April 6 (Saturdays 9am-2pm) | Please fill out this form to order pine needles from H2O Student Ministry.

Customer Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Order Details

How many pine needles would you like to order?

*

Pick up or delivery?

*

Please select one option.

Pick up ($5.00 per bale) Delivery ($5.25 per bale - 15 bale minimum)

Date preferred?

*

Please select one option.

March 30 April 6

Delivery time preference?

*

Please select one option.

9:30 - 10:30 a.m. 10:30 - 11:30 a.m. 11:30 - 12:30 p.m. 12:30 - 1:30 p.m. NA

Do you have any special instructions upon delivery? (Where to put the bales, how will payment be made, etc.)

*

Order Confirmation

How will you pay? (We only accept cash or check. Checks can be made out to Vienna Baptist Church.)

*

Please select one option.

Cash Check

Have you reviewed the above information? Do you agree to pay the total amount for these pine needles?

*

Please select one option.

Yes

Description

March 16 - April 6 (Saturdays 9am-2pm)

Please fill out this form to order pine needles from H2O Student Ministry.

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