Majestic Bloom Order Form

Today's Date: * +

Order Needed by: * +

What time do you need your order by: *

First Name *

Last Name *

Email Address *

Phone Number *

Preference of contact to discuss and secure your order( I will contact you as soon as possible) : *

Cell

Email

What city do you reside in? *

+-

Do you need delivery or will you pick up? *

I need delivery

I will pick up

If you selected “delivery”, please provide me here the address of location so that I may know the distance.

How did you find or hear about Majestic Bloom? *

Please share with me your budget ( I ask this so that I can work within your budget)? *

What type of arrangement are you interested in? *

What color scheme for the flowers would you like me to use? (Amount of colors able to use in one single bouquet is dependent on the size/quantity of stems in the bouquet you choose) *

If you selected one of the bouquet options from the list above, how many flower stems would you like?

If you selected "Flower Vase Arrangement”, what size would you like?

Small

Medium

Large

X-large

If you selected a “Money Bouquet”, how many bills in total will you want me to use in the bouquet(can go up to $500 worth in bills)?

Tell me any more details that you want on your bouquet, describe your vision: *

If possible, please attach pictures of an example/idea/inspiration arrangement you would like me to recreate/reference so that I have a better understanding of what you would like. If you do not have a picture to provide, I may provide you with examples.

Would you like to add any additional items to your order ($3.00 - $6.00 per add on selected)? *

What is your preferred method of payment (for deposit and remaining balance)? *

Before submitting this order form, this statement must be acknowledged. I understand that I will have to pay a 50% non-refundable deposit from the total cost of my flower arrangement to place/secure my order(no deposit means no order placed). *

I understand and agree

I do not agree