Time Flower florist

Order Sheet

Tel :  886-6-2283342
Fax :  886-6-2412561
1. Item informations (required fields are marked with a red asterisk * )
*item number *item name(description) *qty *price texts
               
web site : www.timeflower.com.tw  
email : timesflower@hotmail.com
2. Customer informations (required fields are marked with a red asterisk * )
*Name   *id number  
*phone number  (day) phone number (night)
*E'mail   Fax number  
Address  
*Payment credit card *Expiry     (mm)/       (yy)
   *credit card number :  _ _ _ _-_ _ _ _-_ _ _ _-_ _ _ _
  *CVC2 code : __ __ __
   
3. Recipient informations (required fields are marked with a red asterisk * )
*Recipient name   E'mail  
*Phone number  (day) Phone number (night)
*Delivery date   *Delivery time 09:00 ~ 13:00
12:00 ~ 18:00
17:00 ~ 20:00
*Address      
Texts  
      
Message (heading)
  (content)

 

  (signature)
where do you know about us
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  friend   Promotion email

ps. Please print this page, fax to us after you fill this order sheet.