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Teacher Delivery Form
First name
*
Last name
*
Email
*
Phone
What school are you ordering for? (Flinn, Sissonville Elementary, Sissonville Middle, Sissonville High) ↓
Short answer
Multi choice
*
Midnight Kiss (Acai, Blue Razz, Pink Star)
Cotton Candy Lemonade (Pink Star, Cotton Candy, Lemonade)
Watermelon Sangria (Watermelon, Pink Star, Coconut)
Pineapple Colada (Pineapple, Coconut)
Turtle Tea (Pineapple, Coconut, Blue Razz)
Pink Drink (Raspberry, Lemonade, Pink Star)
Punch Blast (Strawberry, Pink Star, Lemonade)
Blue Jolly Rancher (Blue Razz, Blue Blast, Green Apple)
If you want multiple of one flavor please list here!
Short answer
What day and time would you like the delivery?
Date and time
Month
Day
Year
Time
:
Hours
Minutes
AM
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