Patio Planter Program Request Form

First Name *

Last Name *

Phone *

Email *

Address

Street Address *

City *

State *

Country *

Postal code *

Pickup or Delivery *

I Will Pickup

Please Deliver

When do you need your planters completed and/or delivered by? *

How many planters do you need? Please list container sizes as well *

Budget - What is your preferred budget for these planters? *

Planter Placement - Sun Requirements *

Full Sun

Part Sun

Shade

Please select all that apply

Planter Placement - Placement Direction *

North

East

South

West

Please select all that apply

Planter Design (view from all sides or just front)? *

360 Degree (all sides)

180 Degree (just front)

Special Requests - Colours (please list any special colour requests)

Please let us know any additional information to help fulfill your request.

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

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