8/3/2019 2011 Poinsettia Sale Info & Order Form

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2011 Poinsettia Saleto Benefit Hemophilia of Indiana Order Form

www.hoii.orgPLACE ORDER BY DELIVERY/PICK UP DATE

11/28 11/3012/5 12/712/12 12/14

Color Quantity Price TotalRed $Pink $White $

Hanging Basket $

TOTAL ORDER $

Date of Order

Delivery Date for order of 25 or more plants, in Greater Indianapolis(Check 1) November 30 December 7 December 14

Pick Up Date at Hemophilia of Indiana Office, 5172 E. 65 th Street #105, Indianapolis IN 46220(Check 1) November 30 December 7 December 14

Church/Business/Group Name

Name (or Contact Person)

Address (Mailing)

Address (Delivery, if different)

City ZIP

Phone Cell Phone

Email

Please send me an invoice Cash on Delivery (must be approved in advance) Check is Enclosed (payable to ―Hemophilia of Indiana ) Credit Card (please circle): Visa, Mastercard, Discover, American Express

Cardholder Name Security Code

Account Number Expiration Date

Signature

To Place Your Order Fax 317-570- 0058 (―Attn Poinsettia Order ) Email mperigo@hoii.org Thank you and Toll Free 800-241-CURE Happy Holidays! Mail Hemophilia of Indiana, Inc.

5172 E. 65th Street – Suite 105 (note new address from 2010)Indianapolis IN 46220

8/3/2019 2011 Poinsettia Sale Info & Order Form

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2011 Poinsettia SaleA Benefit for Hemophilia of Indiana

Thank you for your support of Hemophilia of Indiana. Your poinsettia plant

purchase contributes to the programs and services that Hemophilia of Indianadelivers to 1,200 Indiana residents and families who are impacted byhemophilia, von Willebrand disease and other bleeding disorders.

Some of these services include —

Youth and Teen CampsSupport Groups for Men, Women and the Spanish-speakingEmergency Financial AssistanceMedicAlert ® MembershipsDental InsuranceAnnual Bleeding Disorders Conference

Placement of Free Educational Materials in School LibrariesTraining For Teachers, Coaches, School Administrators, School Nurses and Purdue Extension Staff Information and ReferralAdvocacy

POINSETTIA PLANTSFlorist QualityAvailable In Red , Pink , and WWWhhh iiittt eee 5-7 Blooms per 6 Plastic Pot Wrapped in Red or Green Foil 16 -18 in Height $10 per Plant for 25 or More (includes FREE DELIVERY in Greater Indianapolis$12 per plant for order less than 25 (must be picked up at Hemophilia of Indiana office)

Delivery to Other Indiana Cities Available. Call 800-241-CURE for more information.

HANGING BASKETSFlorist QualityAvailable in Red Only7 Plants in 8 Plastic Basket 24 -28 in Diameter

ORDERING AND DELIVERY SCHEDULEDelivery within Greater Indianapolis Only for Orders of 25 or More Plants. Call Toll Free 800-241-2873 to Askabout Delivery to Other Indiana Communities.

Place Order Delivery/Pick Up Date(s)November 28 November 30December 5 December 7December 12 December 14

PAYMENT DUE ON DELIVERY/PICK UP (INVOICING AVAILABLE FOR COMMERCIAL ACCOUNTS)

QUESTIONS?Contact —Michael Perigo at 800-241-CURE toll free or mperigo@hoii.org