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Mothers Day Order Form
OPTION #1: CLASSIC BOUQUET
Please Select and Size and Quantity:
Small Signature Bouquet - SOLD OUT
Medium Signature Bouquet - SOLD OUT
Large Signature Bouquet - SOLD OUT
Would you like to add a vase to your bouquet?
Small Vase - 20
Medium Vase - 25
Large Vase - 35
OPTION #2: VASE ARRANGEMENT
Please Select and Size and Quantity:
Classic Round Centerpiece MEDIUM - SOLD OUT
Classic Round Centerpiece LARGE - SOLD OUT
WOW Factor Round Centerpiece - SOLD OUT
Signature Rectangular Table Centerpiece MEDIUM - SOLD OUT
Signature Rectangular Table Centerpiece LARGE - SOLD OUT
ANY SPECIFIC NOTES?
OPTION #3: DESIGNER SPECIALTY
Please Select and Size and Quantity:
Garden Style Vase Arrangement Designers Choice - SOLD OUT
Basket of Blooms for Mom - SOLD OUT
OPTION #4: POTTED PLANTS
Please Select and Size and Quantity:
Potted Hydrangea in curated pot - $135
Potted Blooming Succulent in curated pot - $75
ADD ON: SWEETS & TREATS
PLEASE SELECT AN OPTION:
Dozen Assorted French Macaroon Box - $36
4-Pack Rose Vanilla Cupcakes - $20
Half Dozen Rose Vanilla Cupcakes - $30
ANY SPECIFIC NOTES?
ADD ON: GREETING CARD/MESSAGE
Complimentary Small White Card - $0
Hayfields Greeting Card - $3
Curated Greeting Card - $5
What would you like the message/card to say?
ADDITIONAL INFORMATION
Any specific requests or needs?
RECIPIENT CONTACT INFORMATION
Recipient First Name
*
Recipient Last Name
*
Recipient Street Address
*
Recipient City
*
Recipient State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Recipient Zip Code
*
Recipient Phone Number
*
Recipient Email Address
*
PURCHASER BILLING & CONTACT INFORMATION
Purchaser First Name
*
Purchaser Last Name
*
Purchaser Zip Code
*
Purchaser Phone Number
Purchaser Email Address
*
PICK UP OR DELIVERY?
OPTIONS ARE:
*
PICK UP AT THE STORE - NO CHARGE
LOCAL DELIVERY $15 (North Salem area)
REGIONAL DELIVERY $25 (12 miles +)
NATIONWIDE DELIVERY - TBD
SPECIAL INSTRUCTIONS?
Pick up or Delivery Date:
*
+
Pick Up or Delivery Time:
Between 9am - 12pm
Between 12pm - 2pm
After 2pm
Extra Notes: Call Ahead? Leave at the Front Door? Leave in the Heated Garage?
Current Total (tax will be added at time of purchase of 8.375%):
$0.00
Calculate
Billing Information: We charge a 4% processing fee along with Westchester County 8.375%. tax.
Card Number:
*
Credit Card Type
*
Visa
MasterCard
American Express
Discover
Expiration Date (mm/yy)
*
CVV:
*
Would you like to leave a tip?
10%
Yes
15%
Yes
20%
Yes