Get Your Flowers!

Number Email Week

Full Name

First

Last

Email Address

Phone Number

Preferred Subscription Week

Select the week you wish to pick up your flower subscription. Only 12 spots available per week.

Alternate Subscription Week (if your first choice is full)

Please select a backup week in case your preferred week is unavailable. Only 12 spots available per week.

Acknowledgement

Please confirm you understand pickup is at Foundry Coffee shop in Lenexa from 9am-11am on the specified date.

Additional Notes (Optional)

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Wellsville, KS 66092