Please print this page - fill in all indicated options and mail or fax to us - any questions - please call!

 

Gift of the Month Club

 

Membership at

The Concord Flower Shop

109 Thoreau Street

Concord, Mass.  01742

Phone (978) 369-2404   Fax (978) 287-6114

 

CHECK ONE OPTION (A, B or C)

 

-A-  ______

$35/month

A seasonal assortment of fresh cut flowers arrives unarranged for the person who enjoys making their own arrangements.

-B- ______

$45/month

Seasonal flowers artfully arranged in a basket, vase or decorative container.

-C- ______

$40/month

Each month receive a different surprise, we will alternate cut flowers, arrangements and flowering plants.

 

 

 

 

January___  February___ March___ April___
May___ June ___ July ___ August___
September___ October___ November___ December___

Check the option you want and the months you want your gifts to arrive and complete the details below.  We'll do the rest!  Your gift will arrive the 1st week of each month unless you request a specific date.  A gift card will arrive with your first delivery telling about your unique and thoughtful gift.

Check Town:  ___Acton    ___Bedford    ___Boxboro   ___Carlisle   ___Concord  

 

 ___Lexington___Lincoln   ___Littleton   ___Maynard   ___Sudbury

 

Deliver to:  ______________________

Address: ________________________

               ________________________

Phone:    ________________________

Card Message:

BONUS:  Order 6 months or more and NO DELIVERY CHARGE! - Otherwise please add $5 per month

Prepay in full and receive these discounts:

For 3-5 months DEDUCT 5%

For 6-8 months DEDUCT 10%

For 9-12 months DEDUCT 15%

 

Total months amt. $_________

(LESS DISCOUNT) $ _________

Plus 5% MA Tax $ _________

Delivery Charges   $_________

Total Amount $_________

Method of Payment:

___M/C    ___VISA   ___CHECK

Card Acct# _______________________

Expires: _____________

 

Signature: ___________________

Date: ___________

 

Your Name: _________________________

Address: ________________________

________________________________

 

Phone:______________ 

Fax: ______________

 

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