Mrs. Flowers' Order Form
Mrs. Flowers Tel. 662-930-3196 Fax 662-513-2961(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:/td>  

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.

SPECIAL!!!
Add your personal touch.Something special for him/her 



Message :  
Special Requirement:  
Payment Method:  
Credit Card Number:   ***Required for  VISA and Master--Card has opted to require the last three digit of your credit card number. You can find them in the back of your card, printed on your signature pane--your order cannot be process without these numbers*** 
Card Holder's name:    
Valid Thru:   (required)
   
     
   


Mrs. Flowers 19 Phaholyothin 21 Rd. Ladyao Jatujak Bangkok Thailand 10900
Tel. 662.930-3196 Fax. 662-513-2961
E-mail:mrsflowersinfo@yahoo.com

 
Home - - Today's Special - - Roses - - Chocolates - - Orchids - - Hampers - - Wines - - Flowers - - Sympathy
- - Exports - - About us - - email us - - Map - - Flowercare - - Links