The Country Garden Plant Centre
Hadnall, Shrewsbury, Shropshire SY4 3DH
Tel 01939 210 380   Fax 01939 210 766
E-Mail : info@countrygardenroses.com

NAME YOUR OWN ROSE
ORDER FORM

All roses on these services are containerised and available all year round.

Containerised roses despatched Monday-Friday Only
Roses despatched on Friday will be delivered Monday
No deliveries Saturday or Sunday

Prices
Name Your Own Rose £39-95

WE DO NOT SEND ROSES
OUTSIDE THE UK MAINLAND

NAME YOUR OWN ROSE

  PLEASE USE BLOCK CAPITALS

Name Required: 


Message Required
on Greetings Card : 

(Maximum twelve words)
DATE FOR ROSE
TO ARRIVE? 		 
Amount Payable :
 
£39-95
 
PLEASE KEEP A COPY OF THIS ORDER
 

PAYMENT DETAILS

   
Payment Method : Cheque      Credit Card
 
Please charge my :  Visa     Mastercard     Switch
Credit Card Number : 
Issue date : /  
Expiry Date : / Issue Number : 
Last 3 digits of
Security Number 		 
 

CONTACT NAME & ADDRESS

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Name : 

Address : 
Post Code : 
Telephone : 
Email : 
 

DELIVERY ADDRESS (if different from above)

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Name : 

Address : 
Post Code : 
Telephone : 
Email : 
 
 If there is no one in at this address during delivery hours, please add instructions
 (i.e. Please leave by back door)

SPECIAL INSTRUCTIONS :
 

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