Deliver To Name:
Relationship to Sender:
Delivery To Address Number and Street:
Appartment #:
Town:
State (VA or DC):
Zip Code:
Phone number at this address:
Delivery Locale Description: (residence, building name, restaurant name, school name, etc.)
Delivery Time Preference	9am-Noon 11am-2pm 1pm-5pm 4pm-7pm 6pm-9pm
Delivery Day Preference	Sunday (February 12- $50) Tuesday (February 14- $50)
Name and Greeting: (exactly as you would like it on the card):
Special Instructions: (please contact us by phone if this is complex):
Full name of person ordering:
Your Email Address: (Confirmation of Order will be sent to this email)
Your Daytime Phone Number: (To contact you for clarification or delivery problems)
Your Evening Phone Number:
Please tell us how you heard about this offer:
The Fine Print Due to limited quartet availability, all order requests are subject to acceptance by The Culpeper Minutemen. Orders will only be accepted when accompanied by payment. You will be notified when your order request has been accepted and scheduled. You will also be notified if your order cannot be accepted and your payment will be returned. Please order early to assure the most favorable consideration. Last year we totally maxed out our ability to deliver singing valentines. You will receive a full refund if the order is accepted but cannot be delivered for any reason on our side of the agreement. However, if we appear ready to perform at the agreed upon time and location, but the named recipient is not available, then no refund will be given. Rescheduling cannot be guaranteed after midnight Saturday, 11 February.
2 songs, card, single rose and a mini box of candy are included in the package When you have completed the form, click on ORDER below. Payment will be made on the following page.