V A S E S
 

 

Choice of colors
Spring Summer, Fall or Winter

       28.50 tax included

    
 

 

Carnations available in red, white, pink, yellow, mauve and orange

     46.68 tax included

 

 

 

Roses available in red, cream/pink and yellow  (2 days notice required for yellow)

     77.52 tax included

 

 

PLACE YOUR ORDER

RECIPIENT'S

 

NAME:  

ADDRESS:  

CITY:  

PROVINCE:  

PHONE #:  

CARD MESSAGE:  

COLORS  1st & 2nd CHOICES:

 

SENDERS

NAME:  

ADDRESS:  

CITY:  

PROVINCE:  

POSTAL CODE:  

PHONE #:  

 

DELIVERY DATE:  

 

Payment Method

Charge to my VISA
Charge to my MasterCard
Charge to my American Express
Charge to my Discover

CREDIT CARD #:  
EXP DATE:  
NAME ON CARD:

Please print this form and fax to:
1-204-748-2425

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