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Flower ORDER FORM

SENDER'S FIRST NAME 

SENDER'S LAST NAME

RECIPIENT's FIRST NAME 

RECIPIENT'S LAST NAME 

EMAIL

PHONE NUMBER

OCCASION (Mother's Day, ANNIVERSARY, BIRTHDAY, JUST BECAUSe, Sympathy, baby ETc.) 

PICK-UP OR DELIVERY? (pick up address: 2751 Main Street - Unit B East Troy, WI 53120)

DELIVERY ADDRESS  (If going to a business please list the name of business or building also) 

HOW DID YOU HEAR ABOUT US?

Looking for Mother's Day flowers or wanting to send flowers for another celebration? As always, Remington's uses a unique variety of blooms & intricate designs. Our minimum on the flower arrangement is $100.00 - A delivery fee will be added on top.

*Please Note: The selection of the floral arrangement & design is up to the designer's choice.
If you have any specific flowers or colors you'd like to see, please let us know. 
Pick up & Delivery available - Store hours are by appointment only
NO SAME DAY ORDERS 

If you are a future bride, please fill out our submission form by clicking here.

BUDGET OPTIONS for the flowers $100, $150, $200, $250, $300, +

RECIPIENT's PHONE NUMBER

CARD MESSAGE (PLEASE KEEP THIS SIMPLE AND SWEET & don't forget to sign it with your name

Are there any specific colors or flowers that you would like us to include?
(*Please Note: The selection of floral arrangements is up to the designer's choice.)

PICK-UP DATE & TIME (NO SAME DAY ORDERS)

DELIVERY DATE (NO SAME-DAY DELIVERY)