FORM B FOR GIFT CERTIFICATES

Step 1: Choose Delivery Options

Other Currency Options (US Dollars | Euro | Pound/Sterling)

Item 1
$100 Gift Certificate	Quantity: I would like to: Have this item mailed to recipient at no cost Have this item delivered in our container stuffed with a chocolate bar (view details) (Includes delivery charge of $ 4.99) Pickup up this item from The Flower Po

Total Price for this selection:

Delivery Times, please choose from these ranges: Before 1:00 pm Between 12:00 pm to 5:00 pm Between 3:00 pm to 7:00 pm

Step 3: Choose Delivery Location (Where is this being delivered?)

Where is this being delivered?

Recipient Information

First Name: * Last Name:*


Address:*

Delivery Zone, Please select which area of greater Montreal:

City:* Province/State:*

Country: Postal Code:


Home Telephone Number:*
Work/Business Telephone Number: ext:
Mobile/Cellular Number:
Email:

Step 4: Provide Billing and sender's information

Payment Options (How would you like to pay for this?)

Sender Information / Please Provide your Contact Details

First Name: * Last Name:*


Address:*

City:* Province/State:*

Country: Postal Code:


Home Telephone Number:*
Work/Business Telephone Number: ext:
Mobile/Cellular Number:
Email:

Would you like an invoice for this order?

If yes, choose how you would like to receive your invoice: