order form
We accept PayPal, personal checks or money orders. Please fill out the order form and indicate method of payment. If you're paying through PayPal, we will request payment through PayPal's service. Thanks for your order!
(Fields marked with "
*
" are required.)
Contact Information
*
First Name:
*
Last Name:
*
Home Phone:
-
-
*
E-mail Address:
Method of Payment
*
PayPal
Personal Check
Money Order
Billing Information
*
Address Line 1:
Address Line 2:
*
City:
*
State:
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennesee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code:
Shipping Information
Same as billing address
First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennesee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP Code:
Product
Unit Price
Quantity
Floral Song -- .25 oz.
$16.00
Floral Song -- 2 oz.
$35.00
Southwinds -- .25 oz.
$16.00
Southwinds -- 2 oz.
$35.00
Lost Roses -- .25 oz.
$24.00
Lost Roses -- 2 oz.
$45.00
Shipping and Handling
$5.00
Total
Comments