Special Form

SPECIAL ELYSIUM

$500
An elevated, styled curation, presented in a transparent box. Made to be seen before it's opened.
Your Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Delivery Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Delivery Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should this be a surprise?
RECIPIENT'S INFORMATION

For surprise gifts, please leave the recipient’s contact information blank.
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Gender
Occasion
A detail about them that would shape this gift (e.g hobbies, lifestyle, scents, flavours, etc.)
Allergies or items to avoid (optional)
Which best describes their taste? (select all that apply)

Other
Other (explain)
Favourite colours or colours to avoid (optional)
Must-have items (optional)
Items to avoid entirely (optional)
Any Special Instructions (optional)
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Message for the recipient
PAYMENT DETAILS

We currently accept Interac e-Transfer ONLY. Instructions will be sent with your invoice. Full payment is collected via Interac e-Transfer to confirm your order slot. Our 48-hour cancellation policy applies from the date your order is confirmed.
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SPECIAL ELYSIUM