Please print out this form and return it to:

Warwick City Hall
Clerk's Office
3275 Post Road
Warwick, RI 02886

AMERICAN CANCER SOCIETY
Daffodil Days


Bouquets in vases delivered as anonymous gifts to cancer patients
or others in need by American Cancer Society volunteers.


Bouquets of 10 daffodils $ 7.00 each

Gifts of Hope - $20.00 each

Boxes of 50 Bouquets - $350.00 each
500 Daffodils


Order Deadline: Wednesday, March 3, 2004
Delivery Date: Week of March 22, 2001


Checks payable to the American Cancer Society
Return coupon below to Amy Hagen, City Clerk’s Office
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Order Information – Return to Amy Hagen, City Clerk’s Office

Name:___________________________Dept:_______________Phone:________

Number of Bouquets @ $7.00 = $________________

Number of Gifts of Hope @ $20.00 = $________________

Boxes of 50 Bouquets @ $350.00 = $________________

Total Enclosed $________________