Heart Song, On-Line Order Form, Special Person

For Parent(s)
$200.00 Package
(plus postage, and processing if applicable)

Once you have completed and submitted this order,
we will contact you to arrange the perfect time for you to hear your song first before you purchase it!
*Unfortunately, Heart Songs are only in English at this time

Your Information

Today's Date: (if you are ordering during a special promotion price, we will know by the date entered.)		Your Name: (The name that will be billed for this order)

Your Email Address:

Your Phone Number for us to call and play the
song for you so that you can approve it before purchase:

How would you like to receive your song when it is finished?
(If are receiving the song outside of The United States. You must choose the MP3 and Certificate option)

mail me the CD
(certificate and lyrics are on the cover)

email me an MP3 file and Certificate
(certificate comes in your choice: Microsoft Word or PDF)

I will pick it up
(certificate and lyrics are on the cover)

Song Information
Please keep in mind that everything you write may not make it into the song,
so please stick to the most important information.

Song Tempo

slow song:

fast song:

Instrumentation

acoustic guitar:

piano:


Name and relationship of person(s) this song is for:

What is it that you love most about your parents?

Tell one or two fond memories (e. g. vacation, romantic getaway...)

Are there any family members or friends that you would like mentioned in the song?

What do you admire most about their parenting?

What kind of person is he/she? What is their heart like?

What morals or values have you learned from him/her/both, and still try to live by?

What does your parent(s) mean to you in your life?

What is the main point that you want to get across in the song?

Anything else that you would like to include:

we will contact you as soon as your order is processed.