Name *

First Name

Last Name

Phone

(###)

###

####

I'd like to order a

Fresh Cut Flowers

Arrangement in Vase

Corsage ($25.00)

Boutineer ($25.00)

With a budget of

$25.00

$40.00

$60.00

$75.00

$100.00

$150.00

$200.00 +

Preferred Method of Payment

We will reach out to you to confirm your order and collect payment within 48 hours hours of receipt

E Transfer (306dayspa@gmail.com)

Credit Card

Cash or Debit (in-person only)

Date Requested for Pick Up or Delivery

We will do our best to accommodate preferred pick-up dates and times and will reach out to you once your order is confirmed and ready.

MM

DD

YYYY