PLEASE
PROVIDE THE FOLLOWING INFO: |
PURCHASER
INFORMATION: |
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Contact
Name |
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Contact
last name |
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Florist
Name |
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Address |
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City |
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State/Province |
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Zip/Postal
Code |
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Country |
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Business
Phone |
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Home
Phone |
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Cell
Phone |
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E-mail |
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RECIPIENT
INFORMATION: |
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CLICK
IF SAME AS PURCHASER AND SKIP THIS SECTION |
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Full
Name |
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Address |
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City |
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State/Province |
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Zip/Postal
Code |
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Country |
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Business
Phone |
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Home
Phone |
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Cell
Phone |
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E-mail |
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PARTY'S
DAY 2022 |
FILLERS SELECT TYPE, SIZE AND QUANTITY - EACH
BUNCH CONTAINS 10 STEMS |
ALSTILBE
ASSORTED: |
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QTY.
BUNCHES: |
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ALSTROMELIA
ASSORTED: |
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QTY.
BUNCHES: |
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ASTER
MONTECASINO: |
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QTY.
BUNCHES: |
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ASTER
PURPLE: |
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QTY.
BUNCHES: |
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DELPHINIUM
ASSORTED: |
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QTY.
BUNCHES: |
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GYPSOPHILIA PERFECTA: |
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QTY.
BUNCHES: |
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LARKSPUR: |
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QTY.
BUNCHES: |
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LIANTRIS: |
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QTY.
BUNCHES: |
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LIMONIUM: |
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QTY.
BUNCHES: |
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MILLION
STAR: |
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QTY.
BUNCHES: |
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PARTY
TIME: |
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QTY.
BUNCHES: |
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SOLIDAGO: |
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QTY.
BUNCHES: |
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STATICE ASSORTED: |
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QTY.
BUNCHES: |
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COMMENTS |
DELIVERY
DATE |
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PARTY'S
DAY 2022 |
FOLIAGE
- GREENS SELECT TYPE, SIZE AND QUANTITY |
AFRICAN BOXWOOD: |
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QTY.
BUNCHES: |
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ASPARAGUS MEYERI: |
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QTY.
BUNCHES: |
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BEAR
GRASS: |
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QTY.
BUNCHES: |
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BOXWOOD: |
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QTY.
BUNCHES: |
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BRUSH
IVY GREEN: |
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QTY.
BUNCHES: |
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BRUSH
IVY VERIEGATED: |
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QTY.
BUNCHES: |
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EQUISETUM HORSETAIL: |
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QTY.
BUNCHES: |
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ESMERALDA: |
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QTY.
BUNCHES: |
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EUCALIPTO
BABY BLUE: |
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QTY.
BUNCHES: |
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EUCALIPTO
SEEDED: |
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QTY.
BUNCHES: |
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EUCPARVI: |
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QTY.
BUNCHES: |
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GALAX: |
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QTY.
BUNCHES: |
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GREVILIA: |
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QTY.
BUNCHES: |
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HUCKLEBERRY: |
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QTY.
BUNCHES: |
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ITALIAN
RUSCUS: |
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QTY.
BUNCHES: |
|
IVY: |
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QTY.
BUNCHES: |
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IVY
ROPE (GREEN): |
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QTY.
BUNCHES: |
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IVY
ROPE (VARIEGATED): |
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QTY.
BUNCHES: |
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JADE: |
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QTY.
BUNCHES: |
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LEATHER
LEAF: |
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QTY.
BUNCHES: |
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LEPTO LAEVIGATUM: |
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QTY.
BUNCHES: |
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LICOPODIUM: |
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QTY.
BUNCHES: |
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LILAC PURPLE: |
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QTY.
BUNCHES: |
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MOSTERAS: |
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QTY.
BUNCHES: |
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PITTOSPORUM: |
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QTY.
BUNCHES: |
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PLUMOSA: |
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QTY.
BUNCHES: |
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SALAL TIP: |
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QTY.
BUNCHES: |
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SPRINGERI: |
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QTY.
BUNCHES: |
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T LEAF ASST: |
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QTY.
BUNCHES: |
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TREE
FERN: |
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QTY.
BUNCHES: |
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VIBURNUM: |
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QTY.
BUNCHES: |
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COMMENTS |
DELIVERY
DATE |
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PAYMENT
INFORMATION (Delivery and Florida taxes charges apply) |
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Credit
card |
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Cardholder
Name |
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Card
Number |
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Expiration
Date |
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(MM/YY) |
SPECIFY
ANOTHER
PAYMENT METHOD: |
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CASH
ON DELIVERY: |
MONEY
ORDER: |
CASH
CHECK: |
CASH
IN ADVANCE: |
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OTHER:
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PLEASE
SPECIFY |
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We
will contact you via e-mail or phone shortly with your order
confirmation |
Please
verify your information carefully before submitting for
ordering |
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