Donation Request Submission Form

Rose Day Orders

Would you like to order roses from us?

Your Order helps us support all our programs!

Here's what you get when you order: 1 dozen long-stem red roses (some limited other colors may be available, you should assume you'll get red), wrapped, and bagged. In addition, you will receive a packet of freshener for your vase.

Please fill out this form and submit it. We'll contact you to confirm your order.

Rose Day

June 4, 2004

$14 per dozen

Name:

Phone Number:

Address:

City:

# of Dozens

Any Special Instructions:

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Sauk Prairie Kiwanis is a 501(c) (6) organization.
Your donation is a purchase and is not tax deductable as a charitable donation.

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