THANKSGIVING FLOWER FORM

VASE ARRANGEMENT OPTIONS

Two Color Ways:
Traditional with a Twist
Textured Neutrals

Rectangle Centerpiece Options:

	Medium - $165
	Large - $195
	WOW Factor Signature - $300

Round Centerpiece Options:

	Medium - $165
	Large - $195
	WOW Factor Signature - $300

ANY SPECIFIC NOTES?

SIGNATURE BOUQUET OPTIONS

Signature Bouquet Options:

	Small Fall Garden Bouquet - $90
	Large Fall Garden Bouquet - $150
	Premium Blooms WOW Factor Bouquet - $210

Would you like to add a vase to your bouquet?

ADDITIONAL INFORMATION

Any specific requests or needs?

Would you like to include a message with your flowers?

RECIPIENT CONTACT INFORMATION

Recipient First Name *

Recipient Last Name *

Recipient Street Address *

Recipient City *

Recipient State *

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?

DATE: * +

OPTIONS ARE: *

PICK UP AT THE STORE - NO CHARGE

LOCAL DELIVERY $20.80 (North Salem area)

REGIONAL DELIVERY $26 (12 miles +) afternoons only

Local Pick Up or Delivery Time:

Between 9am - 12pm

Between 12pm - 2pm

After 2pm

SPECIAL INSTRUCTIONS?

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

Billing Information: We charge a 4% processing fee along with Westchester County 8.375%. tax.

Card Number: *

Credit Card Type *

Expiration Date (mm/yy) *

CVV: *

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