Corsage Order Form

Dance Order Form - Corsages

For Examples and Photos or Options Click Here

Personal Information

* Indicates required field

Name *

First

Last

Email *

Phone Number *

What Event Is The Dance For? *

Date of the Dance *

Pickup Date *

Order Details

What Would You Like to Order? *

Do You Need An Additional Item? *

Yes No

What Additional Items Do You Need? *

Pricing Information
Wrist Corsages Start at $35.00
Ring Corsages Start at $25.00
Fore Arm Corsages Start at $45.00
Boutonnieres Start at $10.00

What Color is The Dress? *

Picture of the Dress *

Max file size: 20MB

Details for the Order? Colors, Flowers Etc. *

Example of What You Are Looking For? *

Max file size: 20MB

Options for Order - Please complete Items that apply to your order

Corsage Options

First Choice for Flower for Corsages *

Corsage Band Options *

Add Rhine Stones *

Regular (+$5.00 each) Iridescent (+$5.00 each) Other Color (+$5.00 each)

*if Other What Color Rhinestones *

Second Choice for Flowers for Corsages *

Add Feather *

Puff (+$5.00) Sprig (+$5.00)

Add Broach *

Add Small (+$9.99) Add Large (+$12.99)

We have a wide variety of ribbon selections - If you do not come in our retail space and pick a specific ribbon dress color will be matched from the photo attached and included in corsage. *multiple ribbons can be chosen in store*

Boutonniere Options

Boutonniere To Match or Flower Choice? *

All Details will be submitted to a JL Designs staff member who will enter the order and send you over confirmation within 48 hours of submission. Please note that all information entered will be subject to supply and stock of items in store. If you have any questions please contact us at 770-267-5061. Our friendly retail staff will be happy to assist you with the order.

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Dance Order Form - Corsages

Corsage Options

Boutonniere Options

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