Simon Says Roses Florists

Canada Flowers & Gifts Order Information Form

All prices are in Canadian dollars...as we are Canadian florists.

1) Please print & review this page. Our staff will require this information to quickly & accurately process your order.

2) Simon Says Roses...Never Closes. Please call now to our live, 24 hour phone lines at:

Toll free: 1-800-705-ROSE(7673) in Canada & the U.S.A.

Item Order Code and Price
Example: (D4-2977: $49.99) for a dozen wrapped roses.

Add an 18" mylar balloon for $4.99. Add a 10" Teddy Bear or Belgian chocolates for $24.99.

Delivery Date

Recipient's Name

Recipient's Full Address: (City, Province, Postal Code & Address)

Recipient's Phone Numbers
Day & Evening with Area Codes

Message & Signature (Maximum 25 words, or a Custom Greeting Card is available for $3.99 if longer messages are required)
Example: Happy Birthday, Mary.  Love, John.

Your Name

 Mailing address where the credit card bill is sent (For your protection, we use address verification to ensure the card is not stolen)

Credit Card Type, Number, Expiry Date, and Full Name as it appears on the card.

Your Phone Numbers Day & Evening with Area Codes

Your EMAIL Address

Your FAX Number

Your customer code or confirmation number as supplied after placing your order.

Toll-free 1-800-705-ROSE(7673) in Canada or U.S.A.

.-- Phone direct 1-250-391-4000 (country code "1")

-- Fax 1-250-391-0563 (country code "1")

Canada florists simonsaysroses@shaw.ca

Private information is protected and is kept strictly confidential.

© 2001-2005 F. & D. Simon, Simon Says Roses Florists