Please Complete This Form Entirely. Drop Off/ Send Order And
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EXTERNAL ORDER FORM (send this one to the Canadian Cancer Society) Please complete this form entirely. Company Name: _______________________________________________________________________ Contact Name: ________________________________________________________________________ Address: ______________________________________________________________________________ Pick up Location (please choose from the list below): _____________________________________________________________________________________ Daffodil Flowers: # of bunches ordered: _____________x $8.00/bunch = Total A $_________ Daffodil Pins: Note: we are not able to pick up unsold pins. Payment is in full for the entire bag of pins # of bags of 50 pins: ___________ x $100.00/bag = Total B $ ____________ # of bags of 100 pins: __________ x $200.00/bag = Total C $___________ Payment Method (please check all that apply) Money Order _____ Cheque(s) _____ Credit Card _____ Cash (do not mail) _____ Credit Card Information: Name of Cardholder: ___________________________________________________________________ Address: ___________________________________________________________________ _____ Visa _____ M/C _____Amex Card Number: __________________________________________ Expiry Date: __________________________________________ Total to charge to card (Total A+ Total B+ Total C): $ ____________________________________ Drop off/ Send order and payment to: Canadian Cancer Society 5826 South Street, Halifax, NS, B3H 1S6 EMAIL: [email protected] FAX: 902.429.6563 Orders and payments due no later than March 6, 2018 If you have questions or concerns, call us 1-800-639-0222. office use only Order received by: ____________________________ Date: _______________________ Payment processed by: ____________________________ Date: _______________________ Data Entry by: ____________________________ Date: _______________________ Presale Pick-up will be available at the following locations on Thursday March 22 from 4-8 pm and Friday March 23 from 10am-1pm. **Workplace Champions please note: The quality of your daffodil flowers will be best preserved by keeping them out of water and at a temperature of 1-2 degrees Celsius if you do not plan on handing them out to your colleagues immediately after pickup. Community Pick up Location Address Halifax Canadian Cancer Society Office 5826 South Street, Halifax ** This location only available 10-2 and 4-6 on Thursday March 22 Halifax Superstore 6141 Young Street, Halifax Halifax Sobeys 6990 Mumford Road, Halifax Halifax Sobeys 279 Herring Cove Road, Spryfield Halifax Sobeys 287 Lacewood Drive, Halifax Sackville Sobeys 752 Sackville Drive, Lower Sackville Bedford Sobeys 55 Peakview Drive, Bedford Bedford Superstore 1650 Bedford Highway, Bedford Bedford Sobeys 955 Bedford Highway, Bedford Dartmouth Superstore 9 Braemar Drive, Dartmouth Dartmouth Superstore 650 Portland Street, Dartmouth Glace Bay Sobeys 144 Reserve Street, Glace Bay Port Hawkesbury Walmart 47 Paint Street, Port Hawkesbury Sydney Sobeys 95 Keltic Drive, Sydney Sobeys 272B Prince Street, Sydney North Sydney Superstore 125 King Street, North Sydney Antigonish Sobeys 151 Church Street, Antigonish Pictou East Walmart 713 Westville Road, New Glasgow Amherst Walmart 46 Robert Angus Drive, Amherst Oxford/Pugwash Save Easy 5185 Main Street, Oxford Springhill Foodland 21 Main Street, Springhill Truro Superstore 46 Elm Street, Truro Bridgewater Superstore 21 Davison Drive, Bridgewater Chester SaveEasy 211 Duke Street, Chester Berwick Doug's Your Independent Grocer 197 Commercial Street, Berwick (Formerly SaveEasy) New Minas Superstore 9064 Commercial Street, New Minas Windsor Sobeys 50 Empire Lane, Windsor Kingston Sobeys 720 Central Avenue, Kingston Digby Sobeys 110 Warwick Street, Digby Yarmouth Sobeys 76 Starrs Road, Yarmouth .