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PLEASE PROVIDE SENDER INFORMATION |
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First Name:
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Last Name: |
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Address: |
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Zip Code:
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City: |
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State: |
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Other
Country: |
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Home phone:
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Work phone:
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Cellular: |
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Email: |
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PLEASE PROVIDE RECIPIENT INFORMATION |
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First Name:
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Last Name: |
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Home: |
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Business:
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Address: |
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Zip Code:
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City: |
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State: |
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Other
Country: |
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Home phone:
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Work phone:
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Cellular:
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Email:
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ORDER BIRTHDAY ARRANGEMENTS |
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DAYLIGHT
BOUQUET |
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BIG
SURPRISE
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BIRTHDAY
PARTY |
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BOUNTIFUL
GARDEN |
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COLOR
FULL SENSATIONS |
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SWEET
BIRTHDAY
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BIRTHDAY
FIREWORKS |
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BIG
HUG ARRANGEMENT |
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BASKET
OF CHEER |
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YOUR
DAY BOUQUET |
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BEST
WISHES GARDEN |
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BEAUTIFUL
DAY |
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BELOVED
BOUQUET |
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BEST
WISHES |
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SUNNY
BEAR |
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BIRTHDAY
WISH |
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FESTIVAL
OF COLOR
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FESTIVE
WISHES
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FLIGHTS
OF FUNNY |
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FLORAL
BALLOON |
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FLORAL
FESTIVAL |
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FLOURISHING
GARDEN |
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NATURAL
WONDER |
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NATURALLY
MINE |
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COUNTRY
FLORAL GARDEN |
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GARDEN
BIRTHDAY |
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SUNSHINE
AND SMILES |
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COUNTRY
BIRTHDAY |
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SUNNY
DAYS |
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JUST
FOR YOU |
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BASKET
OF SMILES |
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HAVE
A GREAT DAY |
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LOVE
IN BLOOM |
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MY
ONE AND ONLY |
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BIRTHDAY
SPLASH |
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BEAUTIFUL
BIRTHDAY |
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BALLOONS |
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CHOCOLATES |
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ORCHIDS |
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SPECIAL
CARD |
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ENTER YOUR CARD MESSAGGE |
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DATE
OF DELIVERY |
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COMMENTS OR SPECIAL INSTRUCTIONS |
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PAYMENT INFORMATION |
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PLACE YOUR
ORDER - WE WILL
CONTACT YOU BY PHONE TO COLLECT YOUR PAYMENT INFO |
PONGA SU ORDEN
- LO LLAMAREMOS PARA PEDIR LOS DATOS DE SU TARJETA |
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Credit Card |
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Card
Number |
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Credit card
Secure Code |
(3 Numbers - see back of your Card) |
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Cardholder Name |
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Cardholder
Billing address |
Complete of Zip code |
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Expiration Date |
(Format MM/YY) |
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We will contact you via
e-mail or phone shortly with your order confirmation. |
Please verify your
information carefully before submitting for ordering. |
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