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CUSTOMER DETAILS
Name (required)

Email (required)

Phone (required)

DELIVERY DETAILS
Delivery Date (required)

ResidentialBusiness

Recipients Name

Business Name (if applicable)

RECIPIENTS ADDRESS
House/Unit No

Street Name

Suburb

Post Code

Phone Number

Card Message


Special Instructions
(ie) security building or where to leave if not at home


REQUIRED ITEMS
Bouquet Cut & Tied (suitable for a vase)Arrangement in Box/Pot
Bright & ColourfulSoft & PrettyPlantFlorist Choice
Flowers in one Colour
Flowers in one Variety

Price Range (required)

EXTRA ITEMS
Vase $25
Candle $18
Chocolates $20
Pot $30
Small Teddy $15
Large Teddy $25

DELIVERY (required)


PAYMENT DETAILS (required)


If paying with PayPal, an invoice for payment will be emailed to the address above within 24 hours.
If Phone Store to Pay is selected, order will not be processed until payment is made.
Please pay promptly to ensure timely processing of your order.

Credit Card Name on Card

Card Number

Expiry

CCV


TERMS (required)
I accept that Verdaflore will make every effort to fullfill my order requests and if I have any questions or concerns regarding my order or stock availability I will contact Verdaflore on 02 9579 6900.

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