Heart Song, On-Line Order Form, Special Person

For That Special Person In Your Life
$150.00 - Regular Package
$200.00 - Wedding Song 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 who this song is for:

What is there about the person that made you fall in love?

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

Do you have any children that you would like mentioned in the song (give names if so)

Is he or she a good mother/father?

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

What do you like to do as a couple or family in your spare time?

What does this person 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.