Steven Ramos
Admin
Posts : 116
Join date : 2015-10-12
![[Format]Marijuana Order Empty](https://2img.net/i/empty.gif) |  Subject: [Format]Marijuana Order Tue Feb 09, 2016 1:22 am | |
| Marijuana Order Customer InformationFull Name:Age:Address:What are you planning on using marijuana for?[]Medical Use []Recreational Use (N/A) If checked medical use answer the following questions below. What is your disability?:Expiation of why you want it. (100 words):Delivery InformationHow many grams?:Type of delivery:[]In store pickup []Delivered straight to the address Customer Signature: - Code:
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[center][size=18][u]Marijuana Order[/u][/size][/center]
[u][b][size=16]Customer Information[/size][/b][/u]
[b]Full Name:[/b]
[b]Age:[/b]
[b]Address:[/b]
[b]What are you planning on using marijuana for?[/b]
[]Medical Use
[]Recreational Use (N/A)
[b]If checked medical use answer the following questions below. [/b]
[b]What is your disability?:[/b]
[b]Expiation of why you want it. (100 words):[/b]
[size=16][u][b]Delivery Information[/b][/u][/size]
[b]How many grams?:[/b]
[b]Type of delivery:[/b]
[]In store pickup
[]Delivered straight to the address
[b]Customer Signature:[/b]
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