Candy Gram Order Form

To (if you're not a NHS employee, please contact HR):*
From (you may write "anonymous" if you wish to do so):*
Customized Note (Optional):
Write a small note to go with your candy gram!
Candy Options ($1 each)*
- Skittles
- Reeses
- KitKat
- Pack of Gum
- Surprise
- Milkyway
- Hershey Bar
- Dove Dark Chocolate Bar
- Protein Bar
Select the candy gram(s) you would like to send!
*Authorization/Payment - by typing my name in this box, I agree to have the appropriate dollar amount for my candy grams deducted from my February 22 paycheck.*