Florals Unlimited - Mail
Credit Card Order
Print out this form, complete it and mail it to:
Wreaths Unlimited, Inc.
186 McAllister Road
Bedford, NH 03110
| Billing Information: (address credit card is billed to) |
| Name: _____________________________________________ |
| Address: _____________________________________________ |
| _____________________________________________ |
| City: _____________________________________________ |
| State: ___________ Zip: ___________ |
| Phone: ______________________________________ |
| Email: ______________________________________________ |
| Print Name on Card: _____________________________________________ |
| Signature as shown on Credit Card: ____________________________________ |
| Card Type: VISA - MasterCard - American Express |
| Card Number: _____________________________________________ |
| Expiration Date: _________________ |
Ship to: (if different from billing address) |
| Name: _____________________________________________ |
| Address: _____________________________________________ |
| _____________________________________________ |
| City: _____________________________________________ |
| State: ___________ Zip: ___________ |
| Phone: ______________________________________ |
| Email:
______________________________________________ |
Qty |
Item # |
Description |
Price |
| _____ | _________ | ____________________________________ | _________ |
| _____ | _________ | ____________________________________ | _________ |
| _____ | _________ | ____________________________________ | _________ |
|
Subtotal |
_________ | ||
|
Shipping |
_________ | ||
|
TOTAL |
_________ |
Include Gift Card Yes/No (if yes, include your personal message below for the Gift Card) _________________________________________________________________