Floral Delivery
Recipient's Name
*
:
Date of Delivery
*
:
Delivery Address
Company Name:
Suite:
Name of Complex:
Unit #:
Street Address
*
:
City
*
:
State
*
:
Zip code
*
:
Phone # cell
*
:
2nd Phone #:
Special instructions for delivery: Timed deliveries are not guaranteed
but we will make an effort to meet your requests!
What arrangement would you
*
like us to send?
Price:
Would you like to send chocolate truffles with your order?
($5.75/13.95/ $20 per box)
Chocolates
Balloons
Stuffed animal
Delivery Fee will be added – see delivery chart for pricing- usually $7 - $12.50
Enclosure Card message
*
:
Your Name
*
:
Email
*
:
Your Phone number
*
:
2nd phone #:
Payment Information:
If you’d prefer not to include your information here, we can call to request
payment information over the phone.
Credit Card Info:
Exp date:
Zip Code:
Would you like a receipt emailed to you of your purchase?
Yes
No
Enter Code
*
:
