Order Request

Order Request
Name*

First NameLast Name
Phone Number
Please enter a valid phone number.
*By choosing to enter your phone number you agree to receive texts from Buku Roses LLC sent from (877)285-8769. Messages may include booking confirmation, price quotes and/or promotional messages. You can OPT out at any time by texting the word STOP. If you do not wish to recieve texts, skip this line.
Email*
example@example.com

Will this need to be delivered? *
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Will you be using a gift card to pay for this order?*

YesNo
If yes, input the gift card code you would like to use:

Pick Up/Delivery Date*

MonthDayYear
Date

Flower Type*

Rose Count*

Wrapping Paper Color*
Other:

Wrapping Paper Style*
If you selected other, upload a picture that best matches your desired look:

Cancelof

If you have any inspiration pics upload them here:

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Should be Empty: