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Order Form

Fields Marked * are required.

All prices have been quoted in Canadian dollars. If your order is being delivered outside Canada the daily exchange rate will apply.

Please be advised that a delivery charge of $14.00 will be applied in the Victoria area and appropriate taxes will be added to your order.

If a vase is specified in the product description you do not have to order one.

* Required Field

You Ordered:

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Sender Information

* Name
* Phone Number
Email
Notes: Let us know if you want extra/different flowers. (Price may change)

Delivery Information

* Deliver to:
* Street Address
* City
* Province/State
Postal Code/ZIP
Country
* Phone Number of Recipient (required for delivery)
* Delivery Date

Please remember to sign your card message

Card Message
* Credit Card Type
* Credit Card Number
* Expiry Date
* Three or four digit security code (CSC) from back of credit card

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