Memorial Order Form

Ship flowers Overnight or Next Day to

Everlastings Flowers, 915 SE Vito Dr. Crystal River, FL 34429

If sending photos, please note that it is important for us to SEAL the design, so we will need a photo ASAP.

Date flowers are shipped:

Month

Day

Year

Name of the deceased:

Phone number: (type +1 before your area code)

Address of where you would like the order shipped to:

Name of your flower shop/florist:

Contact email address:

Contact Cell Phone Number: (Place the #1 before area code)

Please tell us what you would like for us to design. See example below. The more information you can provide, the better.

“I would like a 8 by 10 simple elegant gold frame including the prayer card and 5 bookmarks with the name and dates of the deceased and 2 6 by 6 tiles with In Loving Memory Of”

It is a good idea to talk by phone for very specific orders to discuss colors, types of flowers you may wish to include, poems, prayer cards, etc. Call us at 978-346-8931

Funeral Home and FH contact person:

Payment Information

Upon placing your order, you will be contacted to discuss the total cost.

A required deposit of 50% will be charged using the card provided, and the remaining balance will be charged once the order is shipped.

We do not accept American Express.

I give permission to charge this card for the deposit amount and remaining balance.

Please provide us with a Credit or Debit Card # (We DO NOT accept American Express)

Expiration date:

Security code:

Billing Zipcode

Billing Address:

Name on the card:

If applicable, who referred us? We'd love to say thank you!

Please take note of the statements below.

Due to the perishable nature of your flowers, it’s essential that they are shipped via Overnight or Next Day delivery.

Ensuring your flowers arrive in good condition is key to creating a high-quality pressed piece. Please note that we cannot be held liable for any delays or damages caused by the shipping carrier during transit.

While we strive to include as many of your blooms as possible in the design, some flowers—such as berries and succulents—may not preserve well. Rest assured, we will make every effort to incorporate meaningful elements from what you provide.

There’s no extra charge for including additional flowers, like those for other flower arrangements you'd wish to include.