Valentines Day Pre-Order Form

Order Date

Date

Customer Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about us?

Special instructions on flower colors, or any design preferences:

If you ordered a coffee carrier, how do you plan to pickup?

Leonard's Coffee Roasters (Johnstown, OH)SGT. Coffee Co (Gahanna, OH)I need delivery!

PROCESS: All orders will be delivered by 2/13/2026 unless further instructions are given. IF YOU ARE PRE ORDERING A COFFEE CARRIER, PLEASE SPECIFY WHICH COFFEE SHOP YOU WILL PICKUP FROM OR IF YOU NEED DELIVERY! If picking up from a listed coffee shop, no delivery fee will be incurred.

PAYMENT METHOD: If you reside outside of 43023 or 43081 zip codes, you will be charged a $15 delivery fee. If you do not add that to your order below, a seperate invoice will be sent to you & must be paid on or before 2/6/2026 for your order to be finalized.

SALES TAX: Sales tax will be applied based on the state the customer resides or where is ordering from.

My Products

Balloon BouquetPickup or Delivery Available (Please select delivery add-on below if needed).

$70.00 Color

Coffee CarrierPickup or Delivery Available (Please select delivery add-on below if needed).

$25.00 QuantityPickup/Delivery Option

Small BouquetIf specific colors or design elements are preferred: please list them down below! (Please select delivery add-on below if needed).

$45.00

Medium Bouquet If specific colors or design elements are preferred: please list them down below! (Please select delivery add on, below - if needed).

$55.00 Quantity

Large BouquetIf specific colors or design elements are preferred: please list them down below! (Please select delivery add on, below - if needed).

$70.00 Quantity

Delivery feePlease select if you are unable to pickup your coffee carrier from the listed coffee shops above or you reside out of the 43032 or 43081 zip codes.

$15.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Valentines Day Pre-Order Form

Reminders

Payment Methods