Gig Morris Flower Shop
Order Form
Please print this form and
fax your order to 732-681-3309
Date of Order: ______________________
Date of Delivery: ____________________
To: ______________________________________________
Address: __________________________________________
City: _______________________________ Zip: ___________
Phone: ______________________________
Check off one of each below:
Item: ___ Arrangement ___ Basket ___ Vase ___ Wrapped
Flowers: ___ Mixed ___ Roses ___ Other
Color: ___ Mixed ___Pastels ___Masculine ___Other
Occasion: ___ Birthday ___ Anniversary ___ Maternity ___ Funeral/Sympathy ___Other
Card Message: __________________________________________________________
______________________________________________________________________
Credit Card: ___ MC ___ V ___ AX ___ Dis
Number: ______________________________ Expiration Date ___ ___-___ ___
Zip Code to where your credit card bill is sent: ________________
Name on Card: _______________________________________
Your phone number: __________________ (We will call with the total.)
Signature: __________________________ Date: _________________