Valentines By Kids

Sign-up For Hospitals/Care Facilities

This is the place to sign up if you would like us to send you some Valentine's Day cards for your patients/clients/residents and staff! The earlier you sign up, the better to make sure we have enough Valentine's cards to go around. Sign-ups after January 5 may only be honored if we have enough cards from the children to distribute.

Name of Organization *

Type of Organization *

Contact Person's Name *

Email Address *

How to address you (like "Ms. Anderson") *

Number of Valentine's Day Cards Desired for your patients/clients? *

If we have enough cards, how many extra cards would you like for your wonderful staff?

Street address for delivery to you (no city, state, zip here) *

City *

County

State/District *

Zip Code *

Phone (Fedex requires in case they have an issue - enter 10 digits only - no dashes, no hyphens, spaces, or parentheses): *

Do you want to make this a standing order (we send you the same amount each year) so you don't need to worry about remembering? (Easier for us and for you!)

Any other questions or comments?