Flock a Friend Work Order
Eagle River Panthers Cheer Fundraiser
Your Contact Information
Your Name
*
First Name
Last Name
Your E-mail
*
Phone Number
*
-
Area Code
Phone Number
Address to be Flock
You are responsible for any back lash from your victim or any pay back of a new flocking :)
Name of Victim (I mean friend)
*
First Name
Last Name
Their Address (Location to release the Flock!)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone where you would like photo sent *if you purchased photo evidence only)
-
Area Code
Phone Number
Do you wish to remain anonymous?
*
Yes
No
My Products
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Flock a Friend
$
15.00
Quantity
0
1
2
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9
10
Item subtotal:
$
0.00
Flock a Friend (with photo evidence sent to # of your choice)
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Insurance (protect your home from future flocking)
$
30.00
Total
$
0.00
Pay with Credit Card
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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