Corporate Account Application
If you are interested in setting up an account please fill out the application form.  If you do
not fill out the form completely, it will delay the approval process.  It can take up to 7 working
days to receive your Account number.  Please be patient.  

Thank you.
Ninfa's Flowers
Corporate Account Application Form
Information of person filling out the application
Name of person filling
out form & Phone
number with area code:
Phone Number with
Area Code & Ext.:
Position Title:
Email:
Company Information
Company Name:
Company Address:
Fax Number:
                           Email:
(where you want the
Invoice to go)
Billing Information
Card Holder's Name as
it appears on card:
Check method
of payment:
 VISA
 MASTER
CARD
 AMERICAN
EXPRESS
 DISCOVER
16 digit credit
card number:
4 digit Credit Card
Expiration Date:
 CV2-code number on back of card (3 digits)
American Express number on front of card (4 digits)
Billing Address of Credit Card-
NUMBERS ONLY::
Billing Zip Code of Credit Card:
*Declaration:  Are you authorized by the
Company/Card Holder to apply for a Corporate
Account with Ninfa's Flowers & Gifts?
YES
 NO
By clicking on the Send button, you/& the Card Holder agree that you authorize
Ninfa's Flowers to charge the credit card on file when an order is placed.
You will receive an electronic email to the email you provided
once your order has been charged.

Thank You, We Appreciate Your Business.
Ninfa's Flowers