Custom Botanical Creation
Custom Item & Gift Pack Order Form
I am requesting a quote or ordering as a:
Customer
Retailer
Wholesaler (*Minimum Order for Essential Oils Pure and Blends: 120mL per oil type. Minimum order for non-essential oil products are 12 items.)
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
When do you need to receive this order by?
-
Month
-
Day
Year
Date
Special Order Comments or Questions:
I am requesting a GIFT SET:
Gift Set ($25 value)
GIft Set ($50 value)
Gift Set ($75 value)
Gift Set ($100 value)
Other
I am requesting a CUSTOM Botanical Creation (120mL or 12 count required per custom item):
Bath Salts
Body: Lotion
Body: Herbal Soap
Candle
Environment: Air Freshener
Essential Oil Blend
Hair: Shampoo
Hair: Conditioner
Hair Oil
Self: Bug Spray
Other
Gift Sets I am requesting:
Categories:
All
All
Gift Sets
Candles
Bath Salt
Herbal Soap
Shampoo / Conditioner
Body lotion
Hair & Beard Oils
Air Freshener & Bug spray
Cleaners & Disinfectants
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Gift Sets
Gift Set ($25 Value)
For each set, items chosen should total $25. Please Indicate Quantity of Sets Desired.
$
25.00
Quantity
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Gift Set ($50 Value)
For each set, items chosen should total $50. Please indicate Quantity of Sets Desired.
$
50.00
Quantity
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Gift Set ($75 Value)
For each set, items chosen should total $75. Please indicate Quantity of Sets Desired.
$
75.00
Quantity
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Gift Set ($100 Value)
For each set, items chosen should total $100. Please include Quantity of Sets Desired.
$
100.00
Quantity
1
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Candles
SWEET
Citronella, Lemon Grass.
$
175.00
Size
1 = 12 count
8oz
16oz
HERBAL
Basil, Peppermint, Rosemary, Clary Sage
$
175.00
Quantity
1
2
3
4
Color
8 Oz
16 Oz.
FLORAL
Lavender, Geranium, Ylang Ylang, Chamomile
$
200.00
Quantity
1
2
3
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9
10
WOODY
WOODY - Eucalyptus, Tea Tree, WinterGreen SPICY- Cinnamon, Clove,
$
175.00
Quantity
1
2
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4
5
SPICY
Cinnamon, Clove,
$
175.00
Quantity
1
2
3
4
CITRUS
Citrus - Lemon, Orange, Grapefruit Herbal - Basil, Rosemary, Peppermint
$
175.00
Quantity
1
2
3
4
Bath Salt
Aura Clansing
12 Count Lavender Bath salt 200Oz.
$
250.00
Quantity
1
2
3
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5
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8
9
10
Full Moon Glow
12 Count, Cardamom Bath salt
$
200.00
Quantity
1
2
3
4
5
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8
9
10
Discover
12 Count peppermint bath salt
$
200.00
Herbal Soap
Cinnamon & Turmeric
Classic caesar served with our house made garlic croutons
$
75.00
Quantity
1
2
3
4
5
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9
10
Tea Tree & Neem
A mixed green salad toped with spiced pecans, blue cheese, and cranberries served with a balsamic vinaigrette
$
80.00
Quantity
1
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10
Citronella
Served with crumbled bacon and an orange vinaigrette
$
90.00
Quantity
1
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5
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9
10
Activated Charcoal
$
100.00
Orange
$
90.00
Shampoo / Conditioner
REVIVAL Shampoo / Conditioner
Patchouli, Teatree, & Rosemary essential oils, Organic Aloe Juice, and Other Ingredients.
$
12.50
Quantity
1
2
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11
12
REVITALIZE Shampoo / Conditioner
Pure & Fresh Capsicum, Rosemary, Mandarin, and Tea tree Oils, Organic aloe.
$
12.50
Quantity
1
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12
Your Brand
Make your Secret Recipe
$
12.50
Quantity
1
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12
Body lotion
Lavender
Pure & Fresh Lavender, Coconut, Gareseed Essential oils, and Organic base cream
$
12.50
Quantity
1
2
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4
5
6
7
8
9
10
11
12
Ylang Ylang
Pure & fresh Ylang, Yalng, Coconut & grapeseed oils and Organic Base cream.
$
12.50
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
Chamomile
Pure & Fresh Roman Chamomile, Coconut, Grapeseed Essential oil, and Organic base cream.
$
12.50
Quantity
1
2
3
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5
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7
8
9
10
11
12
Hair & Beard Oils
Hair Care Oil
Hair oil
$
12.50
Quantity
1
2
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8
9
10
11
12
Hair Care oil 2
Hair Oil 2 Ingredients
$
12.50
Quantity
1
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12
Hair Oil 3
Hair Care Oil ingredients
$
12.50
Quantity
1
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12
Gift Ideas 1
$
30.00
Color
Quantity
Red
0
1
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6
Blue
0
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Green
0
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Yellow
0
1
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6
Magenta
0
1
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6
Air Freshener & Bug spray
Air Freshener 1
Air Freshener Formula 1
$
9.00
Quantity
1
2
3
4
5
6
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9
10
11
12
Air Freshener 3
Air Freshener 3 Formula
$
9.00
Quantity
1
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12
Air Freshener 2
Air Freshener Formula 2
$
9.00
Quantity
1
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12
Bug Spray
Bug Spray Formula
$
10.00
Quantity
1
2
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5
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12
Cleaners & Disinfectants
Coming Soon
$
10.00
Quantity
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Credit Card
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Do you want to pick up your order?
Yes.
No, I request for a delivery.
Delivery Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date and Time For Delivery
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
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