Bouquet Arrangement Form

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WelcomeHi there, please fill out and submit your form.

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Name* This field is required.

First Name

Last Name

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Email* This field is required.

example@example.com

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Phone Number* This field is required.

Please enter a valid phone number.

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Candy BouquetIncludes (your choice): Chips, faux flowers, candy, and foil balloon ($10 credit). All credits are included in the final price and for decorative items. *Box and Miniature Candy Only

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Cup BouquetIncludes: BasicTumbler($15 credit),Filler items($35 credit)custom design and arrangement, assembly and presentation. All credits are included in the final price and for additional decorative items. *Stanley Tumblers $50 upcharge

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Bottle BouquetIncludes: Premium flowers($35 credit), *wine ($20 credit), custom design and arrangement assembly and presentation. All credits are included in the final price and for additional decorative items. *wine purchased separately due to licensing restrictions

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Snack “Flower” BouquetIncludes: Coming Soon

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Custom Gift BasketIncludes: Wicker basket ($30 credit), Filler items ($75 credit), custom design and arrangement, and personalized 8x8 canvas. All credits are included in the final price and for additional decorative items. Personalize Your Canvas Below⬇️

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Items you can choose for you arrangement

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PLEASE READ

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Amount Due* This field is required.Cash Only

Candy Bouquet $35

Cup Bouquet $140

Bottle Bouquet $175 (final price $155)

Snack “Flower” Bouquet $225

Custom Gift Basket $350

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Payment Method* This field is required.No bills larger than $20. Thank you.

Cash

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Payment/Meetup* This field is required.Book an appointment to meet and pay for your bouquet/basket. Payment must be paid in full before I begin your order. After 10 minutes your appointment will be cancelled and you will have to reschedule. Meetup location is at the end of this form.

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Pickup* This field is required.Choose a day to pick up your arrangement. Please book at least 2 weeks out from when we will meet for full payment. If you need your arrangement sooner there will be an additional fee of $50 for expedited orders. Please email roguefocusrave@gmail.com immediately after booking. Booking anytime sooner without notice of expedited ordering will result in automatic cancellation. Pickup location is at the end of this form.

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Is this an expedited order?* This field is required.

YESNO

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Signature (Order Agreement) * This field is required.Signing this form is an agreement that you will pay in full for your arrangement and that all sales are final unless stated otherwise. CASH ONLY. No bills larger than $20. Orders are secured in the order payment is received.

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Canvas* This field is required.Please answer none or n/a for all following questions if you are not purchasing an additional canvas or you don’t want the one included in the custom gift basket

8x8 (not included in arrangements) +$100

8x8 (included in custom gift basket)

None

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Pick your crystal style…* This field is required.Choose one of the styles pictured here. You are only choosing the style of the crushed glass not the words. Freestyle will have additional cost. Freestyle’s take more time and creative energy.

Style 1

Style 2

Style 3

Style 4

Style 5

Freestyle (+$45 )

None

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Pick your painting technique…* This field is required.You will choose the technique you’d like to closely match what will be poured for your canvas. Please be reminded that this kind of art is fluid and abstract I cannot remake any design. If you need a better picture of each technique please do a safari engine search. Thanks!

Dirty Pour (mostly no cells)

Flip cup (w/ cells)

Dutch Pour

Tree Ring

Swipe

Freestyle

None

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Short Expressions* This field is required.Please share the short saying you’d like included on your piece. No more than three words with a 10 letter max for each word. Short expressions include (i.e marry me, I love you, my condolences, joy etc). Obscene expressions are welcomed as well! 😉

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What color(s) would you like to add to your canvas?* This field is required.Please specify your preferred colors or color scheme for the piece. If you have particular tones, shades, or combinations in mind, feel free to mention them! Note: Keep in mind that fluid art involves mixing paints with various additives such as pouring medium or other material's that can sometimes subtly alter the final color or appearance. I will do my best to match your vision while embracing the natural flow and unique qualities of fluid art.

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Leave this blank These are just pictures of the embellishments for reference to the next question. Please click none! (everyone)

Gold flakes

Silver flakes

Rose gold flakes

Dried flowers

Crystals (stones)

None

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Embellishments* This field is required.Please choose the embellishments you’a like on your canvas. Every piece comes with crushed glass and acrylic paint pen freestyle design. Note: Crystals should be small no bigger than the size of a quarter. Crystals must be purchased by you. You’re welcome to bring them during our first meet up for the deposit, or if it’s more convenient, I may be able pick them up for you—just let me know, and we can coordinate based on my schedule! Limit two for flakes.

Gold flakes

Silver flakes

Rose gold flakes

Crystals (stones)

Dried flowers

None

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Meetup/Pickup Location

Located in: The Wonder Shops and Flats
Address: 1106 E 30th St Ste E, Kansas City, MO 64109

(Across the street from Ruby Jeans)