Order Request Form

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Order Request Form

Thank you for choosing AgRoses!

After you fill out this order request, a confirmation message will be sent to you with payment details.Once payment has been received, your order will be confirmed.

Price increases for all orders placed in between May 8th - May 14th

First & Last Name *

Phone number *

Quantity of Roses |Bouquets

*In case a larger bouquet is wanted please let me know in "other"

25 ROSES $70

50 ROSES $135

75 ROSES $175

100 ROSES $240

125 ROSES $305

150 ROSES $415

200 ROSES $560

Other kind of arrangement(upload photo in the end)

Other:

Required

Rose Color

*If any other color is wanted, please let me know in "other"

WHITE ROSES

RED ROSES

PINK ROSES

HOT PINK

ORANGE ROSES

YELLOW ROSES

PURPLE ROSES

BLUE ROSES (extra cost)

GOLD ROSES ( extra cost - painted )

SILVER ROSES ( extra cost - painted )

PURPLE WITH PINK TIPS (extra cost)

Other:

Required

Paper Wrap Color

WHITE

PINK

BLACK

BABY BLUE

BEIGE

WHITE WITH GOLD LINING

BLACK WITH GOLD LINING

PINK WITH GOLD LINING

BEIGE WITH GOLD LINING

White WITH WHITE LINING

GRAY WITH GRAY LINING

BLACK WITH BLACK LINING

CLEAR WITH RED LINING

SOFT TEXTURE BEIGE

SOFT TEXTURE WHITE

SOFT TEXTURE PINK

SOFT TEXTURE PURPLE

BLACK DIOR PAPER

BEIGE DIOR PAPER

PINK DIOR PAPER

BLUE DIOR PAPER

Other:

Clear selection

Note Message

Custom Ribbon $12 Please specify what color ribbon

Add ons

CROWN $5

GOLD BUTTERFLIES $4

PEARL BOWS $6

PEARLS $4

DIAMONDS $4

WHITE PEARL INTERIOR WRAP $10

BLACK PEARL INTERIOR WRAP $10

PINK PEARL INTERIOR WRAP $10

WHITE BOWS $3

PINK BOWS $3

RED BOWS $3

Other:

CUSTOM INITIAL $25

CUSTOM ZODIAC LETTERS $30-40

CUSTOM BABY BREATH NUMBER

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