FAX ORDER/PEDIDO
Fax to: Within (en) Mexico SIN COSTO: 01-800-715-9901 OR
Fax our Mexico office direct from U.S.A. 011-52-322-224-8966 OR
  From Other countries: +52-322-224-8966
Telephone/Telefono: Dentro Mexico sin costo 01-800-714-7841, From USA to Mexico: 011-52-322-226-2500

 
Day of Delivery/Dia de Envio______________ (No Sunday deliveries/No Hay Entregas los Domingos)
Name of Recipient/Para Entregar A: _______________________________________________________________________
Street Address/Direccion:_________________________________________________________
Colonia/Fracc/Suburb:___________________________________________________________
City/Ciudad:__________________________________State/Estado_______________________
Zip Code/Codigo Postal:_______________________Country/Pais:_______________________
Tel. # & Area Code/Tel. y Lada (Very Important/Muy Importante):__________________________
Due to small size of floral cards a brief message on card/Mensaje (breve)en la Tarjeta:_______________________________________________________________________
_____________________________________________________________________________
Items requested/Regalos Solicitados:________________________________________________
What Occasion if any/Ocasion:___________________________________________________
Total Amount in U.S. dollars/Precio en U.S. dolares:___________________________________
 
Your Information Please (Para Facilitar este pedido, sus datos por favor):
 
Your name/su Nombre:__________________________________________________________
Address/Dirrecion_____________________________________
____________________________________ City/Ciudad_____________________________
State/Estado___________________Zip/Codigo Postal_____________Country/Pais__________
Day Tel. #/Tel. en la Dia____________________ Eve Tel./Tel. En la Noche________________
Your email address/email direccion:________________________________
Payment Method: Western Union/PayPal/Direct Bank Deposit: ___________________________
For Paypal Pay to : floramex@yahoo.com $_______________
Western Union or Giro Telegrafico Pay to: Ma. Yesenia Pelayo, Puerto Vallarta, Jalisco, MX $_______
For direct bank deposit (Banamex or Bancomer), deposit to: Para Servirle S.A. de C.V.contact us for bank routing numbers via email.
 __________________________Date/dia:__________