Valentine Order Form

2008 Singing Valentine Order Form

This form is for ordering Singing Valentines to be delivered by the Diamond State Chorus and the Top of the Rock Chorus in central Arkansas. For delivery in other areas, please go to www.singingvalentines.com to find delivery options for that area.
Payment is made with Visa, Mastercard, Discover or American Express through Paypal on their secure web site. It is not necessary to sign up for Paypal to use a credit card, but if the Paypal doesn't work, or you prefer to make other arrangements, please tell us in the "Directions for Delivery Address" box below. We can phone you to make arrangements. If for any reason the Valentine is not delivered, your payment will be refunded.

Please tell us how you heard about Singing Valentines. Click the down-arrow and select one:

PURCHASER INFORMATION * indicates required
Title
* First Name
* Last Name
Mailing Address
City
State	Zip
Home Phone
* Work Phone
Cell Phone
* email address


		We would like to be able to send you 2 or 3 flyers a YEAR about upcoming Diamond State Chorus shows and events. If you would like to receive these, please include your address on this page. On the Paypal payment page you will be asked for the mailing address for your Credit Card statement, for verification. We do not receive that address information.

	PLEASE provide phone numbers in case we need to call you about your order or the delivery location! The more contact info you give us, the better we can serve you. We need at least one phone number of any type, in the Work Phone box.

* Quartet gender preferred:	Male Quartet Female Quartet
* Delivery Date:	Thursday, Feb. 14

* Service desired:

* Delivery Time:

4- or 8-hour window ($50)
Telephone Delivery only ($25, see Note below)
Enter:

8 am - 12 noon
1 pm - 5 pm
6 pm - 10 pm
8 am - 5 pm

Specific 2 Hour Window ($70)
Specific 1 Hour Window ($80)
Specific TIME ($100)
Window or Time:

Note: Telephone Delivery is a good choice if the recipient is outside the normal Valentine delivery area. Select a Date above, and one of the 4- or 8-hour windows in the box on the right.

DELIVERY INFORMATION * indicates required
Recipient's Title
* First Name
* Last Name
* Delivery Address
* City, State	,
* Zip	(we need zip for mapping purposes, if you're not sure of it, put 00000)

Contact Person on day of delivery
Contact Phone

Contact Person would be someone at the delivery location who is "in" on the surprise and can help the quartet locate the recipient.

Directions to Delivery Address (Please give any landmarks, intersections, businesses, that would help locate the delivery location)

(type here)

Endearment and Signature for Greeting Card and Special Instructions if any

(type your message)

PAYMENT through Paypal's secure site with Visa, Mastercard, Discover, or American Express. On the next page, please press the "Buy" button corresponding to the cost of the Singing Valentine you have selected ($25, $50, $70, $80, or $100). You will be transferred to Paypal's secure pages to enter credit card information. If the amount paid through Paypal doesn't agree with the selected Valentine, we will phone you to clear up the difference.

The Paypal pages will show as the seller, rather than the Diamond State Chorus. As a member of the Chorus, I share in the Singing Valentine sales work and am responsible for turning in all money from sales, whether made in person or through this Website. (Please click on my email address above and write me if you have any questions.)

Please click on the Submit button below to continue.