Christmas Poinsettia Donation Form

Poinsettias are $10.00. Please make check payable to: [Church Name]

Donated By: Phone Number:

In Memory of:

In Honor of:

In Thanksgiving for:

Number of Poinsettias:

Poinsettias will be placed in the Sanctuary. For other arrangements and for more information, please

contact: at ( ) or email: or

[Contact Name] at ( ) or email: .

For Office Use Only

Amount Due: _____________________________ Amount Collected: _________________________

Payment Type: _______________________________________________________________________

Collected By: _____________________________ Comments: ________________________________

[Church Name] [Church Address] [Church Phone] [Church Fax] [Church Email] [Church Website]