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Your Order of Amaryllis Cases

Your support of our Amaryllis Campaign helps us grow a brighter future! You are enabling us to continue to support families facing Huntington disease, and supporting our search for a meaningful treatment. Each and every Amaryllis we are able to sell brings us one step closer to a world free from HD. Each and every gift is precious. Thank you!

Our commitment to you is to deliver your Amaryllis order at the time that works best for you. Deliveries occur on a Wednesday, Thursday or Friday throughout the campaign. Please tell us when and where you would like to receive your Amaryllis and we will confirm the details via e-mail.

If you have any questions or comments, or suggestions for what would help you with the Amaryllis Campaign, please contact us at amaryllis@huntingtonsociety.ca or call us at 1-800-998-7398.

Thank you again for helping us grow a brighter future!

Your Contact Information
Your Name:
Email Address:
Evening Phone Number:	- - Home     Work     Other
Day Phone Number:	- - Home     Work     Other
The day phone number is the number you will be contacted at if there are any shipping problems.
Option 1: Home Delivery
Our Amaryllis cannot be delivered to a P.O Box. If you have questions about receiving your delivery, contact us HERE
Attention:	If not yourself
Delivery Address:
City:
Province:	-- Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatachewan Yukon Nunavut
Postal Code:
Option 2: Business Delivery
Please provide as much information as you can about how to get Amaryllis to your workplace. If you have questions about receiving your delivery, contact us HERE
Company:
Department:	If applicable
Attention:
Address:
Suite Number:
City:
Province:	-- Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatachewan Yukon Nunavut
Postal Code:
Phone Number (delivery specific):
Company Email:
Order Quantity
	QTY:
Delivery Timing
Preferred Delivery Week:	-- October 10, 2012 October 17, 2012 October 24, 2012 October 31, 2012 November 7, 2012 November 14, 2012 November 21, 2012 November 28, 2012 December 5, 2012
Best day for delivery:	-- Wednesday Thursday Friday
I am buying the amaryllis to	-- Sell to raise money for the HSC For personal use Other