Floral Subscription Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you really REALLY love having flowers around the house and want a fresh bunch every month, this one's for you.

This is the part where we get to know each other.

We hate awkward icebreakers. Type your heart out in the section below so we can get a better idea about who you are, what you're looking for and where we will be delivering your flowers!

Introduce yourself! What's your name? *

How can we contact you? Phone and email please! *

Where would you like your flowers delivered? Leave us the full address and postal code! If we'll be delivering to a business, let us know the business name. Delivery charges vary by how far from the shop you are. *

If this subscription is a gift for someone else, tell us their name and a little bit about them!

Do you have a colour palette you'd like us to stick to? *

Now for the specifics!

Down to business we go.

Preferred sizes and duration *

$50 for 3 months ($150 total)

$50 for 6 months ($300 total)

$50 for 12 months ($600 total)

$70 for 3 months ($210 total)

$70 for 6 months ($420 total)

$70 for 12 months ($840 total)

$100 for 3 months ($300 total)

$100 for 6 months ($600 total)

$100 for 12 months ($1200 total)

Would you like a vase? This adds an additional charge to only your first month! You keep the vase, we refill it every month. *

Yes!

No thanks, I already have a vase.

Are there any birthdays or other occasions happening during your subscription period that you'd like us to deliver for? Let us know what and when they are and we'll make sure your bouquet for that time fits the occasion.

This is important!! Do you know if you or the person we'll be delivering to are allergic to any flowers or plants? *

Payment Info

All payment information is kept secure and confidential. At this time we're only able to take payments by credit card online. If you'd like to pay in cash or e-transfer for your entire subscription length, leave us a note in the next answer box.

Card number (The 16-digit number on the front of your card) *

Expiry date *

CVV (The three digit number on the back of your card) *

Postal code (The one your card is registered to) *

That's it! We'll process your information within 1-2 business days and send you an email confirmation once we have you in our system.

Thanks so much for supporting small businesses. XOXOXOXO The Holden's Team

Here's the place to type any extra comments, instructions, questions, or even just a sweet message!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms