Guarantor Form by ColleenEynon

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									GR3367   Guarantor form arial                    5/26/06          3:12 PM         Page 1

                                                                                                                                                                         Guarantor Form
         u New Application                u Change of Ownership (Teleflora Shop Code #) _____________                         u Branch Shop Application (Parent Shop Code #) ______________

         PART A – Shop Information                            (Please use blue or black ink. Type or print legibly.)

         Shop Name (DBA in full) _________________________________                                           Legal Business Name (if different) _____________________________
         Business Phone # (                      ) ________________ Toll-Free Phone # (                                ) ________________ Fax # (                          ) _______________________
         Physical Shop Address ________________________________________________________________________________________________
         City _________________________________________ County ________________________ State _________ Zip ___________________

         PART B – Guarantor Information                               (Must be filled out completely to process application.)

         NAMES OF GUARANTORS: (If more than two persons, please attach a separate sheet.)
                                                          u Mr.           u Mrs.             u Ms.                                           u Mr.           u Mrs.            u Ms.
         Full Legal Name                              1. __________________________________________                                      2. __________________________________________
         Title                                             __________________________________________                                        __________________________________________
         Social Security Number                            __________________________________________                                        __________________________________________
         Residence Phone Number                           (          ) __________________________________                                    (          ) __________________________________
         Spouse’s Full Name                                __________________________________________                                        __________________________________________
         Present Home Address                              __________________________________________                                        __________________________________________
             City, State, Zip                              __________________________________________                                        __________________________________________
         Previous Home Address
         (If at present address less than 5 years)         __________________________________________                                        __________________________________________
             City, State, Zip                              __________________________________________                                        __________________________________________
         Present Employer                                  __________________________________________                                        __________________________________________
             Present Employer’s Phone # (                            ) __________________________________                                    (          ) __________________________________
             Present Employer’s Address                       _________________________________________                                          _________________________________________
             City, State, Zip                              __________________________________________                                        __________________________________________
             Years Employed                               ________ / ________ through ________ / _______                                     ________ / ________ through ________ / _______
             Position/Title                                __________________________________________                                        __________________________________________

         GUARANTOR’S PERSONAL REFERENCE: (Relat ive preferred; p resent owner not acceptable.)
         Name ____________________________                                 Relationship _______________________                                  Phone # (            ) _________________________
         Street Address ___________________________________                                        City _________________________                        State ______             Zip ________________
         Any notice regarding changes to this agreement must be provided at least 90 days in advance of the effective date of such notice.

         PART C – Guarantor Agreement
         Each of the undersigned guarantors (each, a “Guarantor”), by its signature below, jointly and severally, guarantees, unconditionally, the full and faithful performance by the shop described in Part A of
         this Guarantor Form (the “Shop”) of its obligations to Teleflora LLC (“Teleflora”) under its Contract for Membership (the “Agreement”), a form of which Agreement is set forth on the reverse side of this
         Guarantor Form, and any Other Teleflora Agreement (as defined in the Agreement). Each Guarantor hereby waives and agrees not to assert or take advantage of (i) any right to require Teleflora to
         proceed against the Shop or any other person or to proceed against or exhaust any security held by Teleflora or to pursue any other remedy before proceeding against such Guarantor; (ii) the defense
         of the statute of limitations; (iii) demand, protest, notice of dishonor and notices of any other kind; and (iv) any defense based on the election of remedies by Teleflora. Teleflora and the Shop, subject
         to the terms of the Agreement, may modify the payment or other terms thereof, in each case, without releasing any Guarantor from its liability hereunder. No exercise or non-exercise by Teleflora of
         any right under the Agreement, no dealing by Teleflora with the Shop or any Guarantor, and no change, impairment or suspension of any right or remedy of Teleflora, shall in any way affect the
         obligations of Guarantor hereunder or give any such Guarantor recourse against Teleflora. Each Guarantor acknowledges and agrees that it shall be responsible for keeping itself informed of the
         financial condition of the Shop and of all other circumstances bearing upon the risk of nonperformance by the Shop of the obligations guaranteed hereby, which diligent inquiry would reveal, and
         agrees that Teleflora shall have no duty to provide information to any such Guarantor. The bankruptcy or insolvency of the Shop shall not release any Guarantor of its obligations hereunder. Each
         Guarantor acknowledges and agrees that it has read and understands the terms and conditions of the Agreement. Each Guarantor hereby further grants to Teleflora the authority to obtain credit
         reports and exchange information as described in Section 15 of the Agreement.

         _____________________________________________________________                           ______________________________________________________________                           ____________________
         Print Guarantor Name and Title                                                          Signature                                                                                Date

         _____________________________________________________________                          ______________________________________________________________                            ____________________
         Print Guarantor Name and Title                                                          Signature                                                                                Date

         _____________________________________________________________                          ______________________________________________________________                            ____________________
         Print Guarantor Name and Title                                                          Signature                                                                                Date

                                                                                                                                                                                                          GR3367 05/06

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