65 Roses 2026 - Metro Rose Order

65 Roses 2026 - Rose Order Form
Thank you for supporting 65 Roses Day!

Please place your pre-order below, based on how many individually wrapped roses you think you'll be able to sell at your location.

All roses are sold at $6 each, and every order includes a full information pack to help you get ready for your event. Inside, you’ll find posters, flyers, fundraising tips, and step-by-step instructions on how to deposit your funds.
Before you begin

Please note, this form is for Perth metro rose orders only. For regional WA orders, please use the Regional WA Rose Order Form.
Your Details
First Name*
Last Name*
Email*
example@example.com
Mobile*
Please enter a valid phone number.
Organisation (if applicable)

Rose Order Details

Roses come individually wrapped and ready to sell in buckets of 25 or 50. Every order includes a full information pack to help you get ready for your event. Inside, you’ll find posters, flyers, fundraising tips, and step-by-step instructions on how to deposit your funds.
Large Roses Bucket (50 roses) pre-wrapped
Small Roses Buckets (25 roses) pre-wrapped
Total number of roses ordered
Extra Materials
Do you require any additional materials to support your fundraising? You can request items like banners, tablecloths, or an EFTPOS machine. We'll do our best to supply them where possible, depending on availability.

No thanks, I'm fine with the roses and fundraising kitYes, I would like more resources
Your extra materials will be delivered with your roses and fundraising kit, but will need to be returend to the CFWA office after the event.
Please select any additional materials you'd like from the list below and we'll do our best to supply them.

Banners (variety of indoor/outdoor styles)TableclothsEFTPOS MachineExtra posters/flyersOther
Merchandise Kit - Tick to add a merchandise kit to your order

Merchandise Kit (30 items at $5 each - $150 total value)

Pickup / Delivery Options
Choose to pick up your roses from our office in Nedlands, or have them delivered to you (Perth Metro area only)

1. Delivery

Thursday 28 May 9am-1pm (Perth Metro only, for regional WA orders please see our separate regional order form)

Our roses are delivered by our wonderful volunteer team and we cannot guarantee particular delivery times, please select a pickup option if you require your roses at a specific time.

Deliveries will be left unattended if no one is present, we recommend that someone is available to accept delivery as roses stored outside in sunlight will deteriorate.

2. Pickup CFWA Office

Thursday 28 May 9am-5pm (CFWA Office, 11 Aberdare Rd Nedlands)
Pickup / Delivery:*

Perth Metro DeliveryPickup CFWA Office
Delivery Name*

First NameLast Name
Delivery Address*

Street Address

Street Address Line 2

Suburb

Post Code
Additional Comments
Any additional comments for your order?
Sharing Your Story

Part of 65 Roses Day is about raising awareness of CF. Please let us know if you would be comfortable sharing your story on our socials and in the local media.
Would you be comfortable sharing your story to help raise awareness of cystic fibrosis in the wider community?

Yes I am happy to share my storyNo thanks, I just want to support
(Optional) Your Story - please give us a brief overview of your connection to CF
System Fields
Estimated Rose Value (@ $6 ea)
Salesforce Codes
Salesforce Field - Campaign ID
Should be Empty:

65 Roses 2026 - Rose Order Form