We are also a FedEx Authorized Ship Center!


Fax Order Form

Complete the form below and submit to print a formatted FAX message (please call us for our FAX number). We will e-mail you to confirm your order and delivery charges within 24 hours of receipt. You may also submit a form with no data to print a blank FAX message sheet to complete by hand.

We gladly accept Mastercard, VISA, American Express, Discover and Diners Club.

ORDERED BY:
First Name:
Last Name:
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Email:

RECIPIENT INFORMATION: ( if different from above )
First Name:
Last Name:
Company (If Applicable):
Address:
City:
State:
Zip:
Daytime Phone:

CREDIT CARD INFORMATION:
Card Type:
(Visa, MasterCard, Discover, Amex)
Card Number:
Expiration Month:
Expiration Year:
Name On Card:
Billing Address:
City:
State:
Zip:

ORDER INFORMATION:
Order Description:
Special Instructions:
Brief Card Message:
Delivery Date Requesting:






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Symbolic Rose Colors

Contact Us


Golden Rose Florist
9228 Valley Blvd.
Rosemead, CA 91770

Phone (626) 572-8555
Toll Free (800) 285-0151

FedEx Authorized Ship Center

Track your packages:
Enter your FedEx Tracking Number or Door Tag Number (one per line) below:


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2014 Golden Rose Florist.
All Rights Reserved.