Singing Valentines Order Form
Please fill out a separate order form for each Singing Valentine you wish to send.
Delivery Details
Delivery Option *
Recipient's Name *
Your answer
Your Name *
Your answer
Your Phone Number *
Your answer
Your Email Address *
Your answer
Relationship of Recipient to you *
Your answer
Approximate Time/Time Window (check all that apply) *
(If your Valentine has specific hours at work, or takes a lunch break, etc, please add special instructions in the comment section at the end. If telephone delivery, please note time zone if not Eastern in comment section)
Delivery Town (enter 'Phone' if telephone delivery) *
Your answer
Delivery Physical Address (or PHONE NUMBER TO CALL for telephoned deliveries) *
Your answer
Directions to location (including landmarks), if address not easily found with GPS
Your answer
"Safe" Phone Number (that we can call that day in case of delays, questions, etc.) *
Your answer
"Inside" Contact (if there is someone who will know in advance and take us to your loved one)
Your answer
Song & Gifts
We want to sing the perfect song, so your guidance on genre is needed.
Please select song theme (you may check any that apply)
Please select Rose or Chocolates for the Recipient (only select one) *
Sender's Personal Message for the Recipient (this will be written on a scroll or read via phone delivery) *
Your answer
Special Requests?
Your answer
Payment Options
If you are paying by cash, please hand it in to the person you ordered the Singing Valentine from.

If you are paying by check, please make it out to "Barre-Tones, Inc." and hand it to the person you ordered the Singing Valentine from. You may also mail checks to Barre-Tones, c/o Tracey Coutts, PO Box 913, Waitsfield, VT 05673.

If you would like to pay by Debit/Credit card, please go to and you will find a "Singing Valentine" option on the right. Click on "Buy Now" to pay via Paypal/credit card.

Telephoned deliveries are $20, all others are $40.

Untitled Title
Please select your payment option *
Thank you!
Thank you for your order, and for supporting the Barre-Tones! If you are ordering multiple Singing Valentines, please submit this form and fill out another for each additional order!
How did you hear about Singing Valentines?
Your answer
If you have any questions about this form, please call and leave a message at 802-552-3489 or email
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