Valentine's Day Candy Gram Order Form

Pink flyer with candy, cupcakes, hearts and details about the candy grams.

Freddie Ford Family Foundation Fundraiser

Valentine's Candy Gram for a Cause

Valentine's Day Candy Gram Order Form

Complete this form to order your Valentine's Day Candy Gram(s). Delivery or pickup will be completed by February 14. If your recipient lives outside of St. Louis County, you may choose the $5 mailing option. Email Felicia@freddiefordfamilyfoundation.org with any questions.

You must be 21 years of age to include wine in an adult basket

First Name*

Purchaser's first name.

Last Name*

Purchaser's last name.

Email*

Purchaser's email: example@example.com

Cellphone #*

Purchaser's cellphone.

Recipient's Full Name*

Candy Gram recipient full name.

Recipient's Age*

Candy Gram recipient age.

Recipient's Cellphone number (in case of delivery issues).*

Recipient phone number.

Recipient's Address.*

Recipient street address.

Recipient's City*

Delivery city.

Recipient's State*

Delivery state..

Recipient's Zip*

Delivery zip code.

Who is the surprise gift for this just helps us plan (shhh we won’t share)?*

Write a special message for the Candy Gram recipient.*

Restrictions allergies avoid these ingredients in candy and treats.

Allergens or other items to avoid (ex no alcohol for adult not children).

Order Details and Delivery

$10 Candy Surprise Bag for Kids

$20 Teen/Tween Candy Surprise Bag

$35 Adult Surprise Bag

$5 Mailing Fee is required for recipients outside of the delivery area who are unable to pickup their Candy Gram.

$10 delivery feet for St. Louis City, North County, South County.

Restrictions: allergies, avoid these ingredients.

Pick-up orders 2/13 9AM - 2 PM or 2/14 12:30PM - 3:00PM

I am purchasing an adult basket with wine and I certify that I am over the age of 21 and so is the recipient. If this box is not checked the order will not be processed.

Yes

Purchasers Date of Birth.

Candy Gram*

Small Candy GramSmall candy surprise bag for kids.

$10.00 Quantity
Item subtotal:$0.00

Teen/Tween Candy Gram Large basket for kids.

$20.00 Quantity
Item subtotal:$0.00

Teen/Tween Candy Gram This teen/tween candy gram has no stuffed animal.

$20.00 Quantity

Adult's Candy Gram Large basket for adults with treats and more items.

$35.00 Quantity
Item subtotal:$0.00

Adult Candy Gram with wine Product Image

Adult Candy Gram with wine Must be 21 years and older to purchase.

$45.00 Quantity

Delivery FeeDelivery flat fee for St. Louis City, North St. Louis County, and South St. Louis County. If delivery is not selected for these areas the order will require pickup.

$10.00 Quantity
Item subtotal:$0.00

Mailing Fee There is a mailing fee for 2 or more kids small cups and for each large kids basket and adult baskets. If the mailing fee is not selected but required then the order may not be processed.

$5.00 Quantity
Item subtotal:$0.00

Subtotal

$0.00

Shipping

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay