Poinsettia Dedication

Please complete this form and press SUBMIT. You will then be directed to the payment page. Once you have paid, your order will be complete. Questions? Please contact the office at 574-233-8004 during regular hours (Wednesday through Friday, 10am to 4pm) or send an email to unity@unitymichiana.org. You may take your poinsettia home with you after the Christmas Eve service. Thank you!

Your Name

Name(s) of person you wish to dedicate poinsettia to:

Relationship to you (parent, child, friend, etc.)

Please Check One

Choose Poinsettia Color

Your Email Address

Your Phone Number

Comments

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