Funeral Flower Delivery Order Form

Funeral Flower Delivery Order Form

Order funeral flowers for delivery from Flores Boutique. Please complete all required details.
Assigned Driver (Internal Use Only)
Delivery Status*
Payment Status*
Full Name*

First NameLast Name
Email
example@example.com
phone number
Date Ordered

MonthDayYear
Date
Delivery Date*

MonthDayYear
Date
Funeral Time*

Hour Minutes

AM/PM Option
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sprays – £60.00Hearts – £50.00Crosses – £50.00Wreaths – £50.00Sympathy Bouquets – £50.00Sash / Banner – £5.00VASE £10.00ROSES EACH £5.00Butterfly – £2.00Vase £10.00Single roses £5.00 eachSPRAY £55.NAN £150MUM £150
LU5 – £5.99LU6 – £6.99LU3 – £6.99LU4 – £7.99LU1 – £7.99LU2 – £7.99LU7 – £7.99
Mollie Payment LinkBank TransferPayPal
Total Cost - excluding delivery Charges *
Please note: The total cost does not include delivery charges. A member of our team will confirm the final total and provide the payment details.
Message for Greeting Card
Special Request
Should be Empty: