FLOWERS FOR DELIVERY
Online Order Form

Contact Information:

Your First Name

Your Last Name

As an anti-theft measure, our credit card processing company requires that we have on file the address to which the credit card bill is mailed. If you're using a personal credit card, the credit card statements are typically mailed to your home addess. If you are using a corporate credit card, the statements are usually mailed to your work address. Please furnish the appropriate address below.

Billing Address 1

Billing Address 2

City

State

Zip

Phone (please include your extention, if applicable)

Email Address

Delivery Info:

Recipient's First Name

Recipient's Last Name

Recipient's Address 1 (must be street address -- no PO boxes)

Recipient's Address 2 (name of business, building, complex, suite #, etc.)

City

State

Zip

Recipient's Phone Number (please include extension, if applicable)

Exact delivery times cannot be guaranteed due to traffic, parking and other factors beyond our control. Please call 916.979.9223 to inquire about RUSH deliveries and fees. Also, please call to confirm receipt and processing of orders to be delivered on the same day they were ordered.

Delivery Date

Delivery Time

Morning

Around Noon

Before Close of Business

Other

In the "Arrangement or Occassion" box, please describe the arrangement you would like delivered or indicate the occassion being observed. Don't know what to order? Ask for the Market Arrangement -- your best choice for the fullest & freshest arrangement in any price range.

Arrangement or Occassion

Message for Card

Payment Info:

Price ($50 minimum, plus tax & delivery)

Credit Card Disclosure Alternatives

Type of Credit Card

Credit Card Account #

Exp Date

Questions or Comments

End of Form -- Please Click "Submit"

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