Product Purchase Order Form

Date of Prom*

Date

High School Name: blanks*

Orders on Jotform must be placed ONE WEEK before your prom date. You can still place orders after that time but must be done over the phone (810)653-4177 or in person. If you place an order on Jotform after this cut off date, we will make your order as close as possible but product will not be guaranteed.

Your Name*

First NameLast Name

Dates Name

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Please Enter What Ribbon Number You Want Please click on ribbon color

Ribbon Color

Please Pick One of the 96 Ribbon Colors. Click on the picture to see all color options. Many more color options are available in the store.

$ Free

Standard Wristlet

Standard corsage wristlets will be made on satin ribbon. Occasionally depending on the design they will be made on elastic bands. Ribbon is the new trend and much more comfortable. The ribbon is easily tied around your wrist and is the most comfortable. You can also trim the ribbon to fit perfectly.

$ Free

Premium Wristlets

Premium wristlets are bands that stretch and are either rhinestones or pearls. There are more color options in the store.

$5.00

Standard

5-7 Spray Roses, wax flowers, greenery, and ribbon.

$45.00 Color

Elegant Corsage

Premium Ranunculus Flowers with ribbon, filler flower greens, and embellishments.

$50.00

Premium Orchid Corsage

Orchids, accented with ribbon, greens and embellishments.

$60.00 Color

Glamorous

The Glamorous Corsage is ALL about the BLING!

$60.00 Color

Prom Bouquet

All Prom Bouquets will be custom-made to coordinate with your dress. Each bouquet is unique and no two are the same. All Prom Bouquets are designer's choice.

$50.00

Boutonniere

Magnetic Boutonniere will be made to match the corsage if ordering a set.

$25.00 Quantity

Orchid Boutonniere

Boutonniere will be made to match the corsage if ordering a set.

$35.00 Quantity

Pocket Boutonniere

Pocket Boutonniere is made to sit below the pocket square or on the "top" of the pocket. Pocket Boutonniere will be made to match the corsage if ordering a set

$45.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

DON'T SEE WHAT YOU ARE LOOKING FOR??? Whether it is color or flower choice there are more options available to order in person. Stop in 10182 E Potter Rd Davison or call (810)-653-4177.

Color of Accessories

Please Upload a Picture of Your Dress For Inspiration and the Best Color Match, If You Like!

Pick up of all flowers will be made on the day of prom between 10 am - 1 pm, at Somers Floral Design, 10182 E. Potter Rd, Davison MI 48423.

Terms & Conditions; When you order prom flowers, you are placing an order for a custom, hand-made item. Once your item is created, it is non-refundable. We are happy to make changes or adjustments to your order, but additional charges may apply. You are responsible for choosing the ribbon colors in your corsage. If you'd like to view more ribbon options, please stop by Somers Floral Design. We cannot be responsible for event cancellations. If your event is canceled we will work with you as best we can to adjust or replace flowers.

Prom Corsage, Bouquet, & Boutonniere Order Form