Martin/St Lucie Mariners - Singing Valentine Order Form

Meetings

The Martin/St. Lucie Mariners meet at the North Stuart Baptist Church, 1950 NW Federal Highway in Stuart, Florida every Tuesday
7:00pm - 9:00pm.

Map of 1950 NW Federal Highway
Stuart, Florida

Singing Valentine Order Form

DELIVERY INFORMATION

Recipient Name:

Delivery Date (dd/mm/yyyy):

(If not Valentines Day)

Delivery Time:

9 am to 11 am

10 am to 12 noon

11 am to 1 pm

12 noon to 2 pm

1 pm to 3 pm

2 pm to 4 pm

3 pm to 5 pm

4 pm to 6 pm

Delivery Address:

Delivery City:

Delivery Zip Code:

Delivery address is a:

Residence

Business

Driving/Parking Directions:
(Ex: N of US1, S of Cove Road,
Subdivision, etc.)

Special Instructions:

PURCHASER/CONTACT INFORMATION

Contact Name:

Contact Phone xxx-xxx-xxxx:

Contact e-mail:

Purchaser Name:

Purchaser Phone xxx-xxx-xxxx:

Purchaser e-mail:

PAYMENT INFORMATION

I am paying online.

I will pay by check.

PAYMENT INSTRUCTIONS: Check the box below next to the item to be included in your order. For each box you check, a field will appear where you can enter the quantity for each item you are purchasing.

If you are paying online using PayPal, please also click the button to the right of your selection to include it in your PayPal shopping cart. Clicking on a button will open a new window (or a new tab if you are using tabbed browsing). If you are purchasing multiples of any item, please be sure to update the quantity in the shopping cart to the correct amount. This is a separate process from the order form! Once you click the submit button, you will be taken to a confirmation screen where you will be able to 'View your Cart' and complete your purchase.

If you are paying by check, please make payable to "THE MARINERS" and mail to:

The Mariners
c/o Roger Smeds
4455 SE Tribout Ln
Stuart, FL 34997
Phone: (772) 288-4361

Item	How Many?	Rate
Singing Valentine delivered on Valentine's Day*		$40.00
Singing Valentine on a date other than Valentine's Day* (be sure to indicate date above)		$40.00
Total Payment Amount
Total Payment required =
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*NOTE: We will accept orders for Singing Valentines for delivery, on February 12, 13 & 14, 2010 at the $40 rate. Orders for other dates available by arrangement.

*NOTE: If you want to change your quantity ordered, please uncheck the box at the left first, then check it again and enter the new quantity. This will prevent an incorrect total from being calculated.

If you would like to submit a paper order form for your Singing Valentine instead of filling out this online form, there is a downloadable form here.

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