Form Test

Avenue of Flags Payment

Name *

First

Last *

Last

Address for Flags *

Neighborhood

Postal Code *

Email *

Phone Number *

Billing Address (if different)

Do you have a lawn sprinkler? *

Yes

No

Number of Flags *

Flags (Feb, Mar, Apr, May)

Cost per flag: $55.00

Flags (Feb, Mar, Apr, May)

Cost per flag: $50.00

Flags (Jun, Jul, Aug, Sep, Oct, Nov, Dec, Jan)

Cost per flag: $50.00

Flags (Jun, Jul, Aug, Sep, Oct, Nov, Dec, Jan)

Cost per flag: $45.00

Additional Donation

Total

Sending