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Order ... If delivery is needed within 24 hours, please call 330) 723-8944

Recipient's Name
Delivery Address
Delivery Address
Recipient's Phone Number
Type of Arrangement: (i.e.Fresh Flower Arrangement, Wrapped/Presentation Bouquet,Planter,Wreath,Silk,Gift Basket,etc.)
Price range for arrangement
Delivery or Pick up? Delivery charges will be added to the price of the arrangement.
Date for delivery
Any special instructions for delivery (i.e. use side door, knock loud, at work until 4, etc)
Enclosure Card to read: (signature)
YOUR INFORMATION: Name
Phone Number
Second Phone Number & email address
Credit/Debit Card Number
Expiration Date
DO NOT send your 3 digit security code - skip to end.
Other Special Notes