Full Name*
Email Address*
Phone number*
Account Code*
Purchase order number(If applicable)
Full name*
Address(Please include business name if delivering to a business)*
Is Order for Delivery or Pick Up?* DeliveryPickup: 38 Furlong Road, Sunshine North Victoria 3020
Delivery or Pickup Date*
Delivery or Pickup Time
Order Description:
Order Chocolates: —Please choose an option—Cadbury ($15.00)Lindt ($15.00)
Order Teddy Bear: —Please choose an option—White Colour Extra Small about 12cm($15.00)White Colour Small about 20cm ($25.00)White Colour Medium about 35cm($45.00)White Colour Large about 55cm($60.00)Pink Extra Small about 12cm($15.00)Pink Colour Small about 20cm($25.00).Pink Colour Medium about 35cm($45.00)Pink Colour Large about 55cm($60.00)Blue Extra Small about 12cm($15.00)Blue Colour Small about 20cm($25.00)Blue Colour Medium about 35cm($45.00)Blue Colour Large about 55cm($60.00)Brown Colour Extra Small about 12cm($15.00)Brown Colour Small about 20cm($25.00)Brown Colour Medium about 35cm($45.00)Brown Colour Large about 55cm($60.00)
Order Butterfly: —Please choose an option—Yes($5.00)No Thanks
Order Balloon: —Please choose an option—Small Stick Balloon($5.00)Medium Stick Balloon($10.00)Helium Balloon($20.00)
Order Vase —Please choose an option—Short Vase($5.00)Medium Vase($25.00)Tall Vase($35.00)
Gift Card Type: —Please choose an option—Complimentary White Card (free)Florist Choice($6.95)
CARD MESSAGE
ORDER RELATED COMMENTS:
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