To: Sweetheart's Name *

This is the person TO WHOM we will deliver the Singing Valentine!

First Name

Last Name

Recipient's Used Pronouns: *

He / Him / His

She / Her / Her

They / Them / Their

Other. (What? enter below)

Deliver TO Address

We are only delivering in the Monadnock/Keene region for 2025.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone # (at Delivery Location)

(###)

###

####

CHOOSE WHAT DAY in 2025 *

FRIDAY, FEB. 14 - Valentine's Day 2025

*** Another day. (See NOTE above.) - I'll enter below...

CHOOSE THE TIME WINDOW *

8:00 AM to 12 noon - (4-hour window)

12 noon to 3:00 PM - (3-hour window)

3:00 PM to 6:00 PM - (3-hour window)

6:00 PM to 9:00 PM - (3-hour window)

... other time. I'll enter below...

Your Name *

First Name

Last Name

YOUR Used Pronouns: *

He / Him / His

She / Her / Her

They / Them / Their

Other. (What? enter below)

Your Daytime Phone Number *

(###)

###

####

Your Evening Phone Number *

(###)

###

####

Your Personal CELL Phone Number *

(###)

###

####

Best PHONE number to reach you directly: *

Daytime

Evening

Personal CELL

Your Mailing/Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are we emailing pictures to YOU? or the SV recipient?

Email pictures to me

Email pictures to the recipient of the Singing Valentine

Both!

Don't email pictures