Devine Gift Baskets Hampers and Flowers
Fathers Day Order Form 2009
Devine's use S.S.L. Encryption to secure your information.

To order Quality Flowers or Gifts Baskets Or Gourmet Hampers,
complete this form and submit it. Or you can print it out and (Fax) it to us.
Only orders for delivery in Australia will be accepted. For orders from Australia going overseas, please phone Devine's on +61 (2) 9588 2555 or Fax +61 (2) 9588 3935.
 
Delivery Date:     ( Please enter date in form dd/mm/yyyy eg 14/10/2009)
Company Name:
Recipients Name:
Address:
Post Code:
Delivery Instructions:
For more items
tell us here, we shall email or call to tell total cost.
Recipients Number:  
Mobile No: 

*All Prices in $AUD.
*Orders To Be In By 10am Friday 4th Septemeber 2009

*Please note: There is no special time delieveries for Easter other than through our VIP service. Orders will be delivered by 5pm

Products

Preferences:


(eg Flower type or Colour as in  Red Roses)
Handling (inc. taxes)


* NOTE: VIP Deliveries, ring for a QUOTE
Card Message
200 Characters:






Devine's will  telephone or email you to confirm this order. Please give a BUSINESS HOURS CONTACT NUMBER and email. This order will not be sent without confirmation.
All Orders will need full personal details of credit card holder !

Cardholder Name:
And Phone No:

Credit Card No:

Exp Date:

Verification No:
*Turn your card over. Place the last (3) numbers above your signature in box*
Type of Card:
Your Name:
B/H Phone:
To help us keep contact with you not just mobiles.
Your Email: