Singing Valentine Order Form
Singing Valentine Order form
Email address *
On what date do you want the Valentine? *
To whom shall the Valentine be delivered? *
Your answer
How can we identify the person (color of hair, height, etc.)?
Your answer
What is the address to which the Valentine shall be delivered?
Your answer
If required, what are the exact directions to get to the location of the Valentine recipient?
Your answer
Singing Valentine delivered within the following time windows: *
Required
The start of the window; or, if selected, the exact time that you would like: *
Time
:
Do you want a second song for an extra $10? *
If you want extra roses, how many at $5.00 per rose?
Your answer
If you need extra cards and candy, how many sets at $3.00 per set?
Your answer
In the event you want to be present during the presentation, do you want to be notified in advance of exact delivery time for an extra $2.00? *
If you wanted to be contacted, at what telephone number can we reach you?
Your answer
If you wanted to be contacted, how many minutes in advance do you want us to call you?
Your answer
What message do you want us to put on the card?
Your answer
To what email address shall we send a digital photo of the presentation?
Your answer
Who are you? In other words, who is ordering this Valentine? *
Your answer
If we have questions about your order, what is the best telephone number for us to call to talk to you? *
Your answer
If the presentation will take place in a restaurant, what is the telephone number of the restaurant?
Your answer
Thank you for your order. As soon as it has been reviewed at the Singing Valentine headquarters, you will receive an email message with instructions on how to pay for the Valentine using a credit/debit card or your PayPal account.
Your answer
A copy of your responses will be emailed to the address you provided.
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