Happy Birthday Gift Basket Order Form

Elena’s custom-makes each Gift Basket to order. We ship nationwide via UPS or you may pickup you basket at our store. After receiving your order, we may contact you to verify your baskets contents, shipping costs, desired delivery date, and billing information. If you would like to request a substitution or have any other considerations, simply specify your desires in the field provided at the end of this order form.
If this is a rush order, please call us at 978-582-9700 for expedited delivery options.

Fields in red are required.

Name

Email Address

Billing Info

Your full name as it appears on your credit card:

Billing address as it appears on your credit card statement:

City: State: Zip:
Telephone (Days): Telephone (Evening): Best Time to Call:

Credit Card Type: Visa Master Card AmericanExpress
Credit Card Number

Expiration Date:

CVV#
(The 3 security digits on the back of your credit card)

Shipping Method:
UPS UPS Overnight Pickup Please Expedite*
* Please call (978) 582-9700 for expedited delivery options after placing your order.

Shipping Info (Not needed for Pickup Orders)

Recipient's Name:

Street Address:

City: State: Zip:

If you have any comments, substitutions, or other
considerations, please add them below:

Happy Birthday Gift Basket