Consultation Form Flowers & Gifts At Roth's - Salem, OR, 97304 - Delivering Fresh Flowers and Gifts

1130 Wallace Rd Nw, Salem, OR 97304

Local: 503-364-8393

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1130 Wallace Rd Nw, Salem, OR 97304

Local: 503-364-8393

Email Us

www.rothsflowers.com
1130 Wallace Rd Nw, Salem, OR 97304

Weddings » Consultation Form

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*Bride's Name:

*Groom's Name:

* Phone #:

Alternate Phone #:

* E-mail Address:

Wedding Date:

Ceremony Time:

Ceremony Location:

Reception Time:

Reception Location:

Delivery or Pickup: Delivery Pickup

Number in Wedding Party: Men: Women: Children:

Total Floral Budget:

Appointment Request Time:

Appointment Request Date:

How did you hear about us?:

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