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Memorial Floral Donation Form
Elizabeth Newman
2021-10-04T15:48:08+00:00
Memorial Floral Donations
Memorial/Celebration of Life
Name of Submitter
*
First
Last
Phone
*
Email
*
Name of Deceased
*
Event date
*
MM slash DD slash YYYY
Location/Venue Name
*
Venue Contact Name
Venue Phone Number
Location/Venue Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Florist/Floral Designer Name
First
Last
Florist/Floral Designer Phone Number
Florist/Floral Designer Email
Description of Flowers
*
example: two standing sprays, 1 basket, 3 vases
Will you be donating the vases/containers?
*
Yes
No
Other details?
We would like to send an acknowledgement to the family and thank them for their kind gesture. Who should we send an acknowledgement to for this donation?
Acknowledgement Name
*
First
Last
Acknowledgement Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
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Martinique
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Mauritius
Mayotte
Mexico
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Monaco
Mongolia
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Montserrat
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Nauru
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Netherlands
New Caledonia
New Zealand
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Niger
Nigeria
Niue
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North Korea
Northern Mariana Islands
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Palestine, State of
Panama
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Paraguay
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Poland
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Qatar
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Virgin Islands, British
Virgin Islands, U.S.
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Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
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