Videogram Individual Order Form

Sender's Name: *

please enter your first and last name

Sender's Email: *

please enter your email address so we can send you a confirmation (please double check spelling)

Sender's Phone #: *

please enter your phone number

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Video Choice: *

Recipient's Name: *

please enter the full name of the person who will receive the singing videogram

Recipient's Email: *

this is the email address we will use to send the singing videogram (please double check spelling)

Recipient's Phone #: *

please enter the recipient's phone number in case the email bounces

Personalized message to be sent:

please enter a personal message exactly as you would like it to appear in the email

Requested Delivery Date: *

Month

Day

Year

please enter the date you would like the singing videogram email to be sent

Requested Delivery Time (CST):

Hour

Minute

please enter the time of day you would like the singing videogram email to be sent (Central Standard Time)

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Once you click the SUBMIT button,

you will be taken to a page to make the payment thru PayPal. A PayPal account is not needed.

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