Valentine's Day 2017 Order Form

Name *
Name
Sender's Name
Sender's Phone Number - We will text you a picture of the design!
Available Options *
Please check box of your selection. Can check more than 1 box if desired for multiple arrangements.
Please provide any necessary notes or specific requests regarding colors, or floral selection:
Chocolate Upgrade
Would you like to upgrade your order with handmade chocolates from Sweet Mary's Chocolates?
Recipient's Name
Recipient's Name
Delivery or Pick Up?
Delivery starts at $12 for the first 10 miles. Each additional mile is $0.50.
When would you like to pick up or have your order delivered? Please list a date and time frame if applicable. $50 minimum order for delivery.
Phone Number required so we can confirm they are available to accept delivery.
Recipient's Address for Delivery
Recipient's Address for Delivery
What would you like the card to say?