Floral Order Form

If you are out of town or not near our store location in the Sheraton Centre Toronto, please complete this floral order form to have flowers ready for pick-up or delivered on the specified day and time. Antique Rose will contact you to confirm the order, and obtain other necessary information prior to processing your order.

Please make sure you provide a telephone number or email address so that we can contact you. Do not specify credit card information on the form.

 
Q: When can I expect Antique Rose to contact me after submitting an order?
Your Name and Contact Information
Name:

Business

Phone:
Country
 
  Area/City Code: Number:  
E-mail:
Purchase Information
Please indicate the item(s) you want to purchase.
Roses: Amount:
  Colour:
    Long stem: Short stem:
           
Arrangement:
   
or
 List Price:
$ Cdn.
 HST:
$ Cdn.
 TOTAL:
$ Cdn.

Prices do not include delivery charges where applicable.

Bouquet:  
     
Message
Please specify the message that you want to provide on the card.
Message:
Pick-up or Delivery Information
Please indicate whether you want to pick up the order from our store location or have it delivered. If delivery is desired, please provide the requested delivery information.
Pick-up: Delivery:
Recipient Name:

Business
Funeral Home:
Hospital:
Telephone: Area Code: Number:  
Full Delivery Address:
City/Town:
Pick-up or Delivery Date:
Pick-up or Delivery Time*:
* Antique Rose will make every effort to deliver within the specified time frame. However, due to order volume, delivery on the specified day may be earlier or later.
Comments
Please specify any comments or directions to Antique Rose that will help us to complete your order.
Comments:

 
Submitted information will only be used by Antique Rose for the purpose of completing an order. No information will be forwarded to a third party. Form will be processed by Response-O-Matic.