ORDER FORM

ORDER FORM

PLEASE FILL OUT ALL FEILDS BELOW. WE CANT WAIT TO ADORN YOUR PESACH TABLE!

My Name*

My Phone Number*

delivery date

Recipient Name*

Delivery Address*

Unit #

City*

State*

New York

Zip Code*

COLOR PALETTE

PURPLE- LAVENDAR

PINKS - BLUSHES

WHITES - CREAMS

PEACHES - CORAL

CRYSTAL

MEDIUM- $110

LARGE - $200

MARBLE ROUND

MEDIUM - $90

LARGE - $145

MARBLE LONG

MEDIUM -$200

LARGE - $300

DELIVERY ROCKLAND COUNTY ONLY $15.00

Message to recipient

Payment Type*

Select or enter value

Credit Card Number*

will be charged when order is processed

Exp Date*

zip code on card*

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