Retail Delivery Order Form Customer InfoName First Last PhoneEmail Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Flower & Pre-RollGovernmintOasis Pre-roll Quantity Price: $5.00 Quantity GovernmintOasis 1/8 Quantity Price: $15.00 Quantity GovernmintOasis 1/2 Quantity Price: $45.00 Quantity GovernmintOasis 1 oz Quantity Price: $85.00 Quantity Upgrade Pre-roll Quantity Price: $5.00 Quantity Upgrade1/8 Quantity Price: $15.00 Quantity Upgrade 1/2 Quantity Price: $45.00 Quantity Upgrade 1 oz Quantity Price: $85.00 Quantity MagicMarker Pre-roll Quantity Price: $5.00 Quantity MagicMarker 1/8 Quantity Price: $15.00 Quantity Magicmarker 1/2 Quantity Price: $45.00 Quantity MagicMarker 1 oz Quantity Price: $85.00 Quantity BubbleGumRuntz Pre-roll Quantity Price: $5.00 Quantity BubbleGumRuntz 1/8 Quantity Price: $15.00 Quantity BubbleGumRuntz 1/2 Quantity Price: $45.00 Quantity BubbleGumRuntz 1 oz Quantity Price: $85.00 Quantity GasTank Pre-roll Quantity Price: $5.00 Quantity GasTank 1/8 Quantity Price: $15.00 Quantity GasTank 1/2 Quantity Price: $45.00 Quantity GasTank 1 oz Quantity Price: $85.00 Quantity PapayaBomb Pre-roll Quantity Price: $5.00 Quantity PapayaBomb 1/8 Quantity Price: $15.00 Quantity PapayaBomb 1/2 Quantity Price: $45.00 Quantity PapayaBomb 1 oz Quantity Price: $85.00 Quantity PreRolls OnlyMoPeaches QuantityPre-roll Only Price: $5.00 Quantity Illemonatti QuantityPre-roll Only Price: $5.00 Quantity Pinnacle QuantityPre-roll Only Price: $5.00 Quantity PapayaBomb QuantityPre-roll Only Price: $5.00 Quantity TotalsSubTotal Excise Tax (15%)Sales Tax (.0875%)Grand TotalUpload an Image of your Drivers License or Gov. IDto verify your age. Drop files here or Select files Accepted file types: jpg, heic, png, gif, pdf, Max. file size: 5 MB. Preferred Delivery Time Morning 8AM-12PM Afternoon 12PM 4PM Evening 4PM-8PM Δ
