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Tulips.Com
P.O. Box 1248
Mount Vernon, WA 98273

Toll Free: 866-488-5477

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Bloom of the Month Signup

You are now submitting information on our secure server. All information you enter is secured and encrypted for your safety.

Please tell us when you would like your flowers shipped:
Our standard shipping dates are Wednesdays, for Thursday delivery. Choose which Wednesday each month you would like us to ship by clicking the corresponding button below (or complete the table below with your custom shipping dates):

	First Wednesday of the Month
	Second Wednesday of the Month
	Third Wednesday of the Month
	Fourth Wednesday of the Month

If not selecting from the standard days above, please tell us when you would like them shipped, for receipt the next day: (Monday thru Thursday ship dates only).

Month	Date
January
February
March
April
May
June
July
August
September
October
November
December

We have selected Mr. Roozen's Suggested Flower Selections for you, however, you may customize your club: (The absence of a radio button indicates that particular flower is not available for shipping during that particular month). Please remember to specify the number of bunches you would like shipped for each month. The minimum is two bunches.

Month	Tulips	Daffodils	Lilies	Oriental Lilies	Irises	Iris/Lily Combo	Lily/Oriental Lily Combo	Tulip/Iris Combo	None	Bunches
January
February
March
April
May
June
July
August
September
October
November
December

Bloom of the Month Club Costs for Mr. Roozen's Selections - (2 Bunches)
Approximate Market Prices as of January 2008 - Including Overnight Shipping, Handling and Sales Tax. (Product is subject to availability and prices are subject to market fluctuations.)

Month	Mr. Roozen's Selections	WA	Cont. USA	AK/HI
January	Greenhouse Daffodils	49.59	46.00	66.00
February	Greenhouse Tulips	58.21	54.00	84.50
March	Field Daffodils	35.04	32.50	52.50
April	Field Tulips	42.58	39.50	59.50
May	Lilies	54.98	51.00	71.00
June	Oriental Lilies	63.06	58.50	78.50
July	Iris/Lily Combo	55.79	51.75	71.75
August	Lily/Oriental Lily Combo	64.14	59.50	79.50
September	Irises	51.74	48.00	68.00
October	Lilies	54.98	51.00	71.00
November	Tulip/Iris Combo	54.44	50.50	70.50
December	Greenhouse Tulips	58.21	54.00	84.50
Total Cost for 12 Months		$642.76	$596.25	$857.25
Average cost per month		$53.56	$49.69	$71.44

Billing Information

Your Name:

Your Address:

Your Address (Line 2):

Your City:

Your State/Province:

Your Zip Code:

Credit Card Information

Your Credit Card Number:

Name on Credit Card:

Expiration Date:

Your Email:

Your Daytime Phone:

Your Evening Phone:

Comments or special instructions:

Delivery/Recipient Information
(if different than billing information)

Recipient Name:
Delivery Address:
Delivery Address (Line 2):
Delivery City:
Delivery State/Province:
Delivery Zip Code:
Recipient Phone:

If you have any color preferences, please let us know so that we can match those to your shipment whenever possible:

Prefrences :

Due to the perishable nature of fresh-cut flowers, they need to be delivered within one day of shipment. If there is no one home, we need your permission to leave the package. During very warm or very cold weather, it is important the package not sit outside very long

Do we have your permission to leave the package if no one is home? (We cannot ship without this permission)

Yes

Is there a particular location it should be placed?

Would you like to include a message with your flower shipments? If so, please enter your message here:

Would you like us to continue to ship flowers each month until you instruct otherwise?

	Yes.
	No, only ship flowers for 12 consecutive months, then cancel my membership.
	No, only ship flowers for the dates or months specified, then cancel my membership.

Would you like the first flower shipment to be sent on our next normal Bloom of the Month Club shipment date which is the first Wednesday of each month?

	Yes.
	Please send the first shipment on this date , for delivery the following day.

Please note: Tulips, Daffodils and Iris are packed 10 per bunch; Peonies are packed 5 per bunch; and Oriental Lilies and Asiatic Lilies are packed 3 per bunch.

If you have any questions, or would be interested in receiving flowers more frequently than once a month, just give us a toll free call at 1-866-4-TULIPS (1-866-488-5477). We would be happy to create a custom program especially for you!

Tulips.Com • P.O. Box 1248 • Mount Vernon, WA 98273 • Toll Free: 866-488-5477
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