Local Representative 

Please fill out the following request for information and a local representative will contact you shortly.  

Items marked with an asterisk (*) are required fields.

 


Contact Information
Your Name*:  
Your Street Address*:
City*:

State*:
Zip*:
Daytime Phone:
Evening Phone*:
Email*:

 


School or Organization Information 
Name of Organization*:
Type of Organization*:
Size of Organization*:

Street Address*:
City*:
State*:
Zip*:
Total Average Retail Sale*:
Desired Start Date*:
Date Group Will Be Deciding*:

 


Brochures 
Fall Gift-wrap Catalog:  
Holiday Collection catalog:

Fall Secondary Catalogs:
Home Delivery Cookies:
Fall Flower Bulbs:
Fresh Balsam Wreaths:
Natural Gourmet Mixes:
Coffee, Hot Cocoa & More:
Frozen Food:  
Frozen Food-Pies:
Frozen Food-Cookie Dough:
Frozen Food-Cheesecake:
Spring Catalogs  
Spring Flower Bulbs:
Create-A-Memory:
Eco-Friendly Fundraiser:

 


Other 
How did you hear about Lavender's?

Comments/Questions/

Additional Information:

 

 

-

 

 

 

 

 

 

Lavender's, All Rights Reserved

 

    Virginia 703.750.0799   Fax 703.935.5976