Text Box: DELIVERY FORM
Customer Name                            Phone

Email                  Address


Recipient Name                Recipient Phone

Recipient Address

Message


Flower Selection       Price        Leis     

Delivery Date                                              Time: before         


Please, Indicate which option that our carrier shall select if the recipient is not home.

                                                


 CARD INFO 

Example: Michael Jackson  4817-0006-2846-5000   334 3 digits on the back of your Visa or Master Cards. 

  submit Card Info with Order Form      Card Expire Date            CV Code above your signature

E-Mail and Phone No                        


Delivery Service Charge: Minimum $7.50  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your CVC/CVV Number is found on the back of your credit card on the signature panel. It is comprised of the last three digits appearing on the signature panel.