

| If you would like to receive an information packet and list of local vendors or would like to schedule and appointment. Fill out this form and it will be forwarded to Wisteria Flower Shoppe. Local vendors include: spas, bakeries, formal wear, invitations, gift ideas, jewelers, banks, function halls, etc. Our packet includes a floral worksheet, budget worksheet, brochure, flower meanings and traditions and many wedding ideas and trends. Phone number is not necessary if email is more convenient. We will respond the next business day. |

| Wisteria Flower Shoppe, LLC 16 1/2 East Broadway, Derry, NH 03038 603-434-4600 - 866-925-6667 - wisteriaflowershoppe@verizon.net wisteriaflowershoppe.com |
| The personal information you provide here is confidential and will be used for Wisteria Flower Shoppe purposes only and will not be given or sold to any other business without your express permission. |