FAX ONE form per recipient to 1-800-745-1957
Type or print clearly - ALL FIELDS REQUIRED - This is order #___of___.
Date: |
Contact Name: |
Contact E-Mail Address:
(for your receipt)
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| Billing
Information:
Must match credit card statement
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USA Shipping Informaton
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(We cannot ship to a p.o. box)
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| NAME |
NAME |
| COMPANY |
COMPANY |
| ADDRESS |
(Physical street address. Inc. suite or apt# if applicable)
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| CITY,
STATE, ZIP |
CITY,
STATE, ZIP - Find Zip Finder |
| PHONE
# |
PHONE
# |
CREDIT
CARD TYPE (check one)
____Visa ____M/C ____Amex ____Discover |
CARDHOLDER'S
NAME
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EXP.
DATE |
| CREDIT
CARD # |
Cardholder's Signature REQUIRED
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3 or 4 Digit Card Verification Value CVV2 help
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Qty:
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Item #: |
Sz/Color: |
Item Name |
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Enter a brief message & signature for your gift card. (Max 150 characters)
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Click here to return to Adorable Gift Baskets
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SHIPPING OPTIONS: - Orders ship within 1-3 business (Mon-Fri) days. Arrival times shown are estimates only and do not include Sat, Sun, holidays, day order
is placed or shipped. Please submit a new order for each individual recipient. All fields are required.
____Gift basket cost
____SubTotal
____Ground arrives in approx. 3-9 business days (excludes HI & AK) ($11.95)
____Arrives in approx. 3-4 business days (excludes HI & AK) ($32.90)
____Arrives in approx. 2-3 business days (excludes HI & AK) ($38.50)
____Next business (Mon-Fri) day (place order by 9 AM, EST ($68.50)
____Hand delivered gifts Fruit / balloons / flower / plants only 24-48 hours ($19.95)
Hospital & Hotel deliveries
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