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Pricing: Small $75, Medium $95, Large $135, Specialty $165+
Full Name
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First Name
Last Name
E-mail
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example@example.com
Your Phone Number
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Recipient Phone Number (for delivery)
*
Delivery Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Flower Arrangment
*
Requested Delivery - Payment will be collected after confirmed delivery window.
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Month
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Day
Year
Date
Special Delivery Instructions / Card Message
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