Barefoot Blooms Order Form
Occasion
*
Birthday
Mother's Day
Anniversary
Father's Day
Thanksgiving
Christmas
Sympathy
Other
Name:
*
First Name
Last Name
E-mail
*
example@example.com
Phone number:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Colour & style of flowers
Please Select
Bright & Colourful
White & Green
Pink & White
Natives
Refined & Elegant
Soft colours
Vase included or hand-tied
Vase Included
Hand-tied (must be present to receive order)
Prices (hand tied)
Standard $45
Deluxe $85
Premium $115
Prices (with vase)
Standard $60
Deluxe $100
Premium $130
Delivery Date Options for Mother's Day
Friday, May 7th
Saturday, May 8th
Delivery Date Options for Father's Day
Friday, June 18th
Saturday, June 19th
Delivery Locations
Across Halifax Regional Municipality - Sackville – Mount Uniacke - West Hants
Pick Up at Barefoot Blooms 4614 Hwy 215 Summerville, by appointment and save 5%
Deliver to: (name)
First Name
Last Name
Receiver's Ph. Number
Receiver's Address Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Personal Message
Is there anything we need to know about approaching your home for delivery? For example, dogs, which door to come to, a time you expect a young child to be sleeping…
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