Leura Blumes Flowers Order Form

Specialising in fabulous flowers and well orchestrated events

DELIVERY FEES

Please add delivery fees to the flower order.
Hartley $40.00
Mt Victoria $17.00
Blackheath $14.00
Medlow Bath $12.00
Katoomba $9.00
Leura $7.00
Wentworth Falls $9.00
Bullaburra $10.00
Lawson $12.00
Hazlebrook $14.00
Woodford $16.00
Linden $17.00
Falconbridge $24.00
Springwood $30.00
Valley Heights $34.00
Warrimoo $37.00
Blaxland $40.00

Fill in the form below and click "Submit" to email the order to us. Please check availability of flowers and prices on Valentines day and Mothers day. We accept Mastercard and Visa. American Express and Diners incur a 4% surcharge. Please enter https://www.leurablumes.com.au into the address bar before you enter your details. The https:// will secure the site. If you would like to fax the order through, please click here.

Your Name: *

Your E-Mail address: *

Your Contact Number: *

Recipients name: *

Delivery address: *

AM or PM delivery & delivery date: *

Description of flowers: *

Do you require a card? *
Yes
No

Message on the card: *

Please detail the type of flowers, either as seen on our website or a custom design.

How much do you want to spend? *

Card type & Credit card number:

Expiry date:

CCV number:

Full name on card: