First Class Service
order form |
Stora
Nygatan 17, 111 27 Stockholm, Sweden, phone +46[0]70 751 56 08, fax
+46[0]8 93 31 19 |
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Please fill out this order form
and send it via Internet or fax. All prices are inclusive Value
Added Tax, messenger and service fee, exluded delivery within less
than 18 hours, when an additional fee of 150 SEK is charged.
*) indicates the fields which must be filled out. |
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Order date: |
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This is what
you have ordered:
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| Product: |
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| Date of delivery:
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*
year/ *
month/ *
day
morning
afternoon |
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| Purchaser |
| Name: |
*
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| Company: |
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| Address: |
*
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| City and postal code: |
*
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| Country: |
*
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| Phone daytime: |
*
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| Phone evening: |
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| Email address: |
*
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Payment
(*You have to choose between invoice or credit card)
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| Credit card
customers |
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Invoice customers |
| Payment via: |
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Customer no:
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| Credit card no:
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| Expire date: |
year/
month |
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| Recipient |
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| Name: |
*
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| Company: |
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| Address 1: |
*
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| Address 2: |
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| Postal code: |
City:*
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| Phone daytime: |
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| Phone evening: |
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| Door code: |
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| If the Recipient of the flowers is
not available, can we: |
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leave the flowers
at the door? |
Yes
No |
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leave the flowers to a neighbour? |
Yes
No |
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| Greetings: (4 rows of 68 characters) |
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| Information to deliverer: (2 rows of 68
characters) |
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This order will be
delivered on the given day if all information on the order is correct
and your credit card payment is approved. If something is wrong we will
try to contact you.
Please check up the form so that all
necessary information fields are filled out. |
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