Virtual Visit Information Form Step 1 of 3 33% Please complete this form once for each video you've purchased. If you've not yet completed your purchase, please first go to the Virtual Visits & Personal Videos page to complete your purchase before completing this form. The next step to delivering a “knock their socks off” video is information.Your Name* Your Email* Please enter your order # from the confirmation email we sent you when you paid: If you've not yet paid, please first complete your purchase. Then return here to complete this form.Person's name this video is for:* Phonetic Pronunciation of name, if necessary What is their age (or approximate age)?* What is their relationship to you?* What is their gender? Male Female What is the primary message you would like conveyed?* Additional information*Add anything else that might add to the fun, an inside joke, a teacher or supervisor's name, a pet's name, a recent accomplishment, a favorite Christmas character, movie, song, game, toy, etc.?Did you pay for the option to have a photo placed in the video?* Yes No What is the image or photo, and what should I say about it?*Now upload the file to our server.Max. file size: 256 MB.CAPTCHACommentsThis field is for validation purposes and should be left unchanged.