Application For Corporate Account
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 & Gifts
Corporate Account Application Form
Contact person for
this application:
Position Title:
Full Names of Persons
Authorized to use this
account:
Email:
Company:
Address::
Phone Number:
Fax Number:
*Trade References:
(2 Minimum)  Please
include Business
Names, Contact
Names, & Contact
Numbers
Cardholder's
Name 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)
Billing Address of Credit Card-
Numbers Only:
Billing Zip Code of Credit Card:
*Declaration:  Are you authorized by the
Company to apply for a Corporate Account
with Ninfa's Flowers & Gifts?
YES
 NO
Questions, comments, or feedback: