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: Selected wine from Mrs. Flowers' 2000 list
Your bottle of these selected items will be deliver to your client with a beautiful bouquet of flowers that will sure to make the right impression

Price: Avialable on the list		.
Selected item:  

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:  
   
     


Mrs. Flowers 19 Phaholyothin 21 Rd. Ladyao Jatujak Bangkok Thailand 10900
Tel. 662.930-3196 Fax. 662-930-3659
E-mail: