Gift Baskets for Business and Personal Occasions

CUSTOM ORDER
Basket Creations
Phone:	(818) 591-8400 or (866) 443-8403 toll free
FAX:	(818) 591-5909
If you would like to custom-design your gift, please fill out the following information and press submit. A representative will contact you to finalize the order.

First Name:		Last Name:

Address:

City:		State:		Zip:

Phone:

FAX:

Email: (for confirmation of order or questions)

What is the special occasion ? (new baby, wedding, new home, thank you, etc.)

Is your gift for a woman, man or other ? (baby*, a couple, etc.) (specify)

(*girl or boy or unknown)

Does the recipient have a favorite color or scent ?(if applicable)

Is there a special theme you would like? (i.e., bath products, snack foods, coffee, movie night*, beach theme, etc.)

(*specify if you would like me to purchase a special movie)

Do you want your gift delivered or shipped?

(Delivery Fee varies from $10.00 to $20.00 depending on where delivered.)

What is the recipient’s name, phone number and delivery or shipping address? Are there any special delivery instructions?

Date you would like your gift delivered:

Would you like a gift enclosure card included (please specify text)?

What is the dollar amount (or range) you wish to spend? (this will determine number of items in the gift)

We will contact you to finalize this order and collect your payment information

Anything else I should know?