Mrs. Flowers' Order form

Mrs. Flowers' Order Form
Mrs. Flowers Tel. 662-930-3196 Fax 662-930-3659(auto 24hr.)
or e-mail us at MrsFlowersInfo@yahoo.com

Item: F6 Pink dainty creation with roses and lilies and a Teddy Bear
With pink roses, daisies and miniature lilies, this basket would sure to bring a smile to anyone's face

Price: $59

Customer e-mail :		(required)
Customer's Name :
Address1 :
Address2 :
City and Country :
Contact Work phone no :		(required)
Contact Night Phone No :		(required)
Deliver to:
Address1 :
Address2 :
City :
Zip Code :
Country :		Thailand
Home Phone : (Bangkok's addresses are not systematic; we need the Tels to verify the location)		(required)
Work Telephone :		(required) Extension :
Delivery Date:		Time : If your desired delivery time is not listed, please use a special requirement form to indicate your preference. We will try our best to accomodate your request.
Message :
Special Requirement: