I wish to send the following items. The charges for the same shall be borne by me and can be collected from my address.
  

Items to send

Mode of payment:

Date of Delivery

Bouquet

Cheque

Date

Chocolate Box

Cash

Month

Cake

Demand Draft

Year


I am sumbitting the necessary details which are mentioned below. Kindly confirm back the possibility of delivering the above mentioned items to the consignee. I have read your terms and conditions and accept the same.
  

Sender's Details

Name:

Address:
(should be complete with city & pincode)

Telephone No:

Fax No:

E-Mail:

Consignee's Details

Name:

Address
(should be complete with city & pincode)

Telephone No:

Fax No:

Email:


Kindly note that the order has to be placed atleast two working days in advance. The confirmation copy shall be mailed back to you on receipt of the payments.