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Exotica Florist - The World is in Bloom!
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Please complete all sections of this order form.


FX4803 - Everlasting

Multiple Orders: To send this item to more than one recipient, or to order
different items, first submit this order. Then select the Next Order link.


Underlined fields are required.  Incomplete forms will not be processed.

Click here for more information about delivery policies and procedures.



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Delivery Date:

Day: Month: Year:


Gift Card Message

Due to size of florists' gift cards, this message box allows for no more than 120 characters.

Enter Message
eg."Happy Birthday!"

Gift Card
Signature:

eg. "Love, Bob"

Billing Information


First Name


Last Name

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Day Telephone

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Delivery Information

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Is recipient's address the same as the billing address?
Check if yes.If not, please complete the Delivery Information below.
We are unable to accept orders for Post Office Boxes or APO's.

Select One Residence Business Funeral Home Hospital Other
Institution / Business Name
Address
City
State/Province
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Phone numbers are required for all rural route addresses
Delivery Instructions

Please specify any delivery instructions. Requests for delivery at specific times of the day can be requested but cannot be guaranteed.
Please Let Us Know...

How did you hear about Exotica Florist?
TV Ad Radio Ad Internet Ad
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Billboard/Outdoor Ad Catalog Family/Friend
Other : (please explain)
Any suggestions?

Please inform me via email of special promotions or discounts.

Discount Club
    
I am registered with the Exotica Florist  Discount Club.
I get 10% off all flower and basket orders, and 15% off all orchid purchases!
    
Place Your Order

Please verify that all of the above information complete and accurate.

OR
Fax to:
619-338-4917.

OR
Print and mail to:
Exotica Florist, 1335 5th Avenue, San Diego, CA 92101.

OR
You may also order by telephone:
619-338-8130 in San Diego
1-800-471-8334 in the US and Canada.

Next Order

 

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