Name *

First Name

Last Name

Phone *

(###)

###

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What type of gift item are you interested in? Select all that apply. *

Container

Wreath

Centerpiece

Potted Amaryllis

Potted Houseplant

Please indicate your budget range (per item), if known. *

$30-$75

$75-$150

$150-$250

$250 +

Not sure