Half Dozen Roses

PLEASE ANSWER THE FOLLOWING QUESTIONS ABOUT YOUR ORDER:

PLEASE NOTE: WE DO NOT DELIVER ON WEEKENDS

Delivery or Pick Up Date:

Sender's First & Last Name:

Sender's Phone Number:

Recipient's First & Last Name (Required for delivery):

Recipient's Phone Number (Required for delivery):

Delivery Address (Required for delivery):

Business Name (if applicable):

Your Card Message:

Flower Color - First Choice:

Flower Color - Second Choice:

Any other notes or special requests?: