Prairie Rose Farm and Floral
Small Wedding + Elopement Intake Form
Congrats!
We are so excited to do flower magic for you. This form is for couples looking to elope or have a small wedding. If you want a full-service custom wedding, you can find out more about those offerings & fill out a separate form on our website. Tell us all about your flower dreams in the form below. We will reach out to you to schedule a phone consultation and work out the details when we receive your answers!
Name (nearlywed #1)
*
First Name
Last Name
Pronouns
Name (nearlywed #2)
*
First Name
Last Name
Pronouns
Best Email
*
example@example.com
Best Phone Number
*
Please enter a valid phone number.
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Day of Contact Name
*
Day of Contact Phone Number
*
Please enter a valid phone number.
Date and Time of Ceremony
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location or Venue of Ceremony
*
Location or Venue of Reception
*
Will you require delivery or pick-up on our farm?
*
If requiring delivery, will you need Set-up?
Event Photographer
*
May we request to access photos of your wedding florals for our social media & website?
*
Yes
No
How did you hear about us?
*
What is your estimated floral investment?
*
What type of celebration are you having?
*
Please Select
Elopement
Small wedding
please choose one
A la Carte Menu
Our A la Carte pricing is listed on our website on the Elopements + Small Weddings page. All table arrangements provided in vases are included in the cost and are yours to keep!
Personal Flowers (Select the items & quantities you would like):
Quantity
Nearlywed Bouquet
Silk ribbon for nearlywed bouquet
Nearlywed Boutonniere
Nearlywed Full floral lapel
Nearlywed Pocket square
Wedding party bouquet
Silk ribbon for wedding party bouquet
Petite bouquet (perfect as a flower-child or toss bouquet)
Silk ribbon for petite bouquet
Wrist corsage (mother of bride, wedding party, etc.)
Boutonniere (officiant, wedding party, father of bride, etc)
Hair comb
Flower crown
Petite flower crown (perfect for flower-child)
Loose hair flowers
Floral dog collar
Ceremony & Reception Flowers (Select the items & quantities you would like):
Quantity
Loose flower petals
Cake flowers
Mini centerpiece
Small centerpiece
Medium centerpiece
Large centerpiece
Grand centerpiece
Bud vases: Set of 3
Bud vases: Set of 5
What color palette best suits your celebration?
*
Dark and Deep
All Whites
Bright and Colorful
Pastels
All Greenery
Earth Tones
Jewel tones
What is your celebration's style?
Wildflower
Whimsical
Boho
Romantic
Garden
Botanical
Woodland
List any specific flowers you love
*
List any specific flowers you don't love
*
Add your Pinterest link if you have one!
Upload any inspo photos you may have!
Browse Files
Drag and drop files here
Choose a file
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of
Add any additional questions or comments here!
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