Fax Order Form

Delivery Date:___________________________________________________________________

Recipient Name:_________________________________________________________________

Recipient Address:_______________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Postcode:______________________________________________________________________

Telephone Number:_______________________________________________________________

Card Message:__________________________________________________________________

______________________________________________________________________________

Order (please circle):      Bouquet       Hand-Tied      Arrangement        Planted Bowl

Colour (please circle):     Bright and Colourful      Pastel Shades        Seasonal Choice

Price (plus delivery):       £25(bouquet and Planted Bowl)  -  £30  -  £40  -  £50  -  £60  -  £100

Delivery (please circle):   Future Day £6  -  Same Day £8  -  AM £9.99  - PM £8.50  -  Internat'l £TBD

Extra (please circle):       Balloon £4  -  Chocolates £5, £10  -  Bear £10, £15

                                      Wine £10 W/R  -  Champagne £15, £25, £38

Senders Name:__________________________________________________________________

Senders Telephone Number:________________________________________________________

Account Name & Order Number:____________________________________________________

______________________________________________________________________________