Order Form
Item Ordered: Item prices do not include tax and delivery charges (within the continental US). Ginger Vase........$50.00 Garden Bouquet.....$59.00 Springtime Basket..$42.50 Bear Hug...........$45.00 Designer Choice....$50.00 T42-1..............$25.00 Feel Better Bouquet$35.00 Heart Bouquet.....$37.50 pink bouquet......$59.99 Fruitful Basket..........$70.99 Classic 40 Ford Bouquet..$35.00 Birthday Bouquet.........$32.50 Stunning Beauty....$55.00 Pacific Paradise...$45.00 Posy Basket........$42.50 Paradise Basket..$40and Up(specify price in Arrangment Modifications Box)
Arrangement Modifications: (use to add to arrangement or request changes): (Note: Additions or Changes may increase the price.)
Occasion: Other Anniversary Birthday Congratulation Friendship Get Well Holiday Love Sympathy Thank You Wedding Happy Thanksgiving Happy Easter Happy St Patricks Day Thinking of you
Card Message: (Please try to keep message below 150 characters.)
Delivery Date Delivery Date can be same day if ordered by 11:00am EST. (Except Sundays and Holidays)
Delivery Date(month/day/year):
Recipient Information (Delivery Info.) (Please provide complete information including Zip and Phone Number.)
Name..................: Company.............: Address Line 1.....: Address Line 2.....: City..................: State/Prov.........: Zip Code...........: Country..............: USA CANADA Telephone Number...:
Additional Delivery Information (use if needed): (Deliveries can not be guaranteed for particular times of day.)
Your Information (Please provide complete information including your home and day phone numbers.)
Name...................: E-mail Address.....: Company.............: Address Line 1.....: Address Line 2.....: City..................: State/Prov.........: Zip Code...........: Country.............: USA CANADA Home Phone Number..: Day Time Phone Num.:
Payment Information
Please select your method of payment:
Please Enter your Account information below:
Name On Card......: Account Number....: Expiration Date...: (MM/YY)
Before submitting your order, please verify that all input information is correct and complete. To process your order, your name, e-mail address and telephone no. is required.