Flower Service Order Form

If you wish to order any of our flower arrangments over our secure server, please complete this form and click on the submit button at the bottom.

If you prefer, you may fill in this form and instead of clicking on the submit button, print it out and fax it to us at: (516) 352-0143

We also take phone orders or can answer any questions you may have. Our phone number is: (800) 598-5666

Your Name:

E-mail address:

Which of the following arrangements do you wish to order:

Order Total:

Where would you like the arrangements delivered (Mailing Address):

Street:

Line 2:

City:

State: Zip Code:

Area Code: Number:

Billing Information:

Name:
(as it appears on the card)

Street:

Line 2:

City:

State: Zip Code:

Card Type:

Card Number:

Expires:

Comments:

*Please Note: All sales are final

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