FUNERAL FLOWERS ORDER

This is a secure form for use by funeral directors only. All information is confidential. Once your order is processed, we will send you an order confirmation by email or fax. If you need further assistance, please call 630-719-5156.

Due to seasonal and supply chain limitations, some flowers are not always available. To ensure timely deliveries of the best products possible, reasonable substitutions may be necessary in some cases.

Deliver On:

By Time:

Funeral Home Ordering:

Account #

Address:

City/Town:

Contact Person/Arranger:

Email:

Phone:

Fax:

Deceased Name:

Male

Female

Deliver To: Same As Above

Address: Same As Above

City/Town:

State:

Phone:

Funeral Piece(s) Requested

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Qty.

Item # or Description

Color(s)

Price

Card Message

Ribbon Script

Total Quantity:

Total Price:

Special Requests / Instructions:

If you have difficulty submitting an order, try removing special characters like @ " % [ ] / < > = $ ? or similar.

* Ribbon Script is $10 each. Please add this to the item price to ensure your family's satisfaction.

** Applicable tax and delivery will be added when your order is received and reflected on the confirmation we send you.

CS = Casket Spray
EP = End Piece
FL = Floor Arrangement
FS = Fireside Basket
TA = Table Arrangement
SH = Satin Heart w/ Cluster(For Inside Casket)
BP = Blooming Plant

SS = Standing Sympathy Arrmgt.
ES = Standing Easel Spray
SC = Standing Flower Cross
FH = Standing Full Flower Heart
OH - Standing Open Heart
RO - Rosary of Roses
GP = Green Plant