WE ARE STANDING BY. CALL 561-622-1843 OPEN 777.

OPEN 7 7 7. SPEEDY DELIVERY SERVICE. Prices include tax and delivery. WE QUOTE TOTAL PRICES.

PLEASE PLEASE READ: To confirm your order you must TEXT the word "SEND" to 561-622-1843. We are standing by. TEXT the word "SEND" to 561-622-1843 to confirm your order.

What zip code are the flowers going to?? NOT LISTED?? UBER YOUR FLOWERS!!!!

Dial A Rose

1837 Pleasant Drive,

NPB., FL., 33408

*

DO NOT SEE YOUR ZIP CODE?? Kindly schedule an Uber:)

Sender Information:

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Delivery Information: Upon completion of this order form you must TEXT the word "SEND" to 561-622-1843.

Delivery Date: * +

Delivery Time: *

Select Bouquet. SELECT BY Price and Name.

WE WORK WITH YOUR BUDGET. YOU CAN AFFORD TO SEND FLOWERS!!

Roses and mixed floral are fresh daily and are while supplies last.

WE WILL DO AN EXCELLENT JOB FOR YOU. Floristry is our Ministry.

PRICES INCLUDE TAX AND DELIVERY. WE QUOTE TOTAL PRICES. No delivery charge.
Please go to www.dialarose.com/photos to see pictures of the bouquets. Call 561-622-1843 for more information or to place a custom order. *

Recipient Information:

First Name *

Last Name *

Business/Community/Building Name (if applicable)

Street Address *

Apartment or Suite Number

City *

State *

Zip Code *

Phone Number *

Is this a gated community? *

If Yes, please enter a gate code, if available

Should we call the recipient before we deliver? *

If the recipient is not at home, may we doorstep? *

MESSAGE CARD: Your message card will read how you display it in the box. Please be sure and sign it if you want your name on the card.

What would you like your message card to read? What is the occasion? PLEASE BE CERTAIN TO SIGN THE CARD AS YOU WANT IT SIGNED: For example: Love, Pookey. ***YOUR MESSAGE CARD will help the designer make your bouquet customized!! *

ANONYMOUS BOUQUETS. Please be advised. ***No signature means NO DISCLOSURE.*** Anonymous Bouquet Disclaimer. ****Disclaimer. Any anonymous bouquet order will be kept confidential and no information will be given to anyone who calls, sender or recipient. WE DO NOT DISCLOSE ANY INFORMATION TO ANYONE FOR ANY REASON, SENDER OR RECIPIENT, FOR ANY ANONYMOUS BOUQUET. IS THIS BOUQUET ANONYMOUS?? YES OR NO. PLEASE ADVISE.

Special Instructions (Optional):

Please enter any special instructions. 1) Please provide the BEST TWO HOUR WINDOW for delivery. 2) Delivery landmarks?? 3) Significant color of roses requested??

Credit Card Information: Mastercharge, Visa, American Express, Discover.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Security Code. PLEASE PROVIDE SECURITY CODE IN THE BOX BELOW. ALSO, PLEASE READ: Upon completion of this order form you must TEXT the word "SEND" to 561-622-1843 for your ORDER CONFIRMATION. Thank you for trusting our fine service. *

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