ONLINE ORDER FORM
Name:
*
First Name
Last Name
Phone number:
*
E-mail
*
example@example.com
Delivery Details:
Deliver to: (name)
*
First Name
Last Name
Receivers Ph. Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Delivery Time Slot
*
Occasion
*
Birthday
Get well soon
I love you
Anniversary
Mothers day
Sympathy
Thinking of you
Congratulations
Other
Description of your flowers! 💐Or as much detail as you can give! 😊
*
Our options!
*
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Petite Bouquet
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Medium Bouquet
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
Deluxe Bouquet
$
130.00
Quantity
1
2
3
4
5
6
7
8
9
10
Vase
Add a vase
$
16.00
Quantity
1
2
3
4
5
6
7
8
9
10
Personalized Card
Feel free to provide your preferred message for the card in the description!
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Submit Order and proceed to checkout
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