Forever Rose Gifts - Mail Order Form

 NAME_______________________________________________________________________________

DELIVERY STREET ADDRESS___________________________________Apt, Suite, Floor____________

CITY______________________________________STATE__________________ZIP________________

E-MAIL ADDRESS_____________________________________________________________________
Can we contact you at this email if we have any questions? (yes / no)
We would be happy to email you your tracking #

HOME or CELL PHONE______________________________________________________
Can we contact you at this number if we have any questions? (yes / no)

ITEM & COLOR CHOICE_____________________________________   QTY______________________

ITEM & COLOR CHOICE_____________________________________   QTY______________________

ITEM & COLOR CHOICE_____________________________________   QTY______________________

ITEM & COLOR CHOICE_____________________________________   QTY______________________

ITEM & COLOR CHOICE_____________________________________   QTY______________________

                                                                                                   TOTAL ORDER QTY.___________________

     SHIPPING ADD $7.95 for domestic orders (FREE IF ORDER IS OVER $75)  ______________________

     ADD PA SALES TAX (6%) ONLY IF SHIPPING WITHIN THE STATE OF PA____________________

                                                               TOTAL $ AMOUNT OF CHECK/MO ENCLOSED_____________
      
 CHECKS AND MONEY ORDERS MAY REQUIRE UP TO 7 BUSINESS DAYS TO CLEAR PRIOR TO YOUR ORDER BEING SHIPPED.


ADDITIONAL INFO (How would you like the order boxed, separately or all together if possible?):

____________________________________________________________________________________________________

____________________________________________________________________________________________________

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The Forever Rose - Forever Rose Gifts - P.O. Box 6 Summit Station, PA 17979
email@theforeverrose.com  - Copyright 2002-20011 - All rights reserved.
Forever Rose(s) is a registered trademark of TheForeverRose.com

Revised: 03/13/11