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Fun City Chorus Singing Valentine Order Form

For more information, call (501) 276-0700

For $40, your Valentine will receive a song, one red rose and a card.
For extra roses, please add $5 for each additional rose.
A box of chocolate-covered strawberries is available for $20.

Your name: *
Your email address: *
Your phone number: *
Additional roses, if any:      Additional roses are $5 each
Chocolate covered strawberries:      A box of chocolate covered strawberries is $20
Payment will be made by:  

Your valentine's name:  
Relationship to Valentine:   (wife, husband, girlfriend, boyfirend, friend, etc.)
Requested singing date:  
Requested singing time:       (Please allow a 1 hour window.)
Singing location:  
Delivery Address: *
City*/State*/Zip Code:       
Special message:  

* = required fields