Name *

First Name

Last Name

Phone *

(###)

###

####

Flower Delivery Preference *

Ship to Covenant Florals

Drop-Off Locally (Tulsa OK)

Estimated Date Your Flowers are to Arrive or be Delivered to Covenant Florals *

MM

DD

YYYY

Address *

United States Only

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your Preservation For?

Wedding

Memorial

Special Occasion

Custom

Product Selection *

Round Floral Block (7"x7")

Hexagon Floral Block (4"x4")

Hexagon Floral Block (6"x6")

Hexagon Floral Block (8"x8")

Square Floral Block (6"x6")

Square Floral Block (10"x10")

Arched Floral Block (10.5"x 6.5")

Bookend Floral Block Set 9"

Rectangle Floral Block (12”x9”)

Serving Tray (Availability Varies)

Jewelry Dish (4"x4")

Ring Tower

Candle Holder

Single Magnet

Magnets Set of 4

What Background Color do you Want? *

Clear

Black

White

Other (I will contact you if you choose this option)

Final Product/s Delivery Preference *

Ship to Client Address Provided

Pick up Locally (Tulsa, OK)

Please read the Client Contract (Below This Form) if you want to see the simplified version of the Flower Preservation Agreement. The highlighted points are what the majority of clients are most interested in. *

I agree to the Client Contract and the Flower Preservation Agreement.