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Blind Date with a Book Submission Form
Blind Date with a Book
"
*
" indicates required fields
Your Name
*
First
Last
Email
*
Blind Date with a Book Packages
*
The Jessica Day - SOLD OUT
The Nick Miller - SOLD OUT
The Schmidt & Cece - SOLD OUT
The Claire Dunphy - SOLD OUT
The Cameron Tucker
The Gloria Delgado-Pritchett
The Cher
The Dionne
The Wednesday - SOLD OUT
The Enid Sinclair
The Thing
Kids Package
Individual Packages - $30/each Couple Packages - $60/each Kids Packages - $15/each
The Jessica Day Package
*
Price:
$30.00
Quantity:
Amount of Jessica Day packages you would like to order.
The Jessica Day: Recipient Name(s)
*
The Jessica Day: Drink selection.
*
Alcoholic package.
Non-alcoholic package.
The Jessica Day: Alcohol Disclaimer - Confirm you are at least 21 to order.
Yes, I am 21 or older.
No, I am not 21 or older.
The Jessica Day: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Jessica Day: Recipient(s) Address
Please list the local address for your package recipient(s).
The Nick Miller Package
*
Price:
$30.00
Quantity:
Amount of Nick Miller packages you would like to order.
The Nick Miller: Recipient Name(s)
*
The Nick Miller: Drink selection.
*
Alcoholic package.
Non-alcoholic package.
The Nick Miller: Alcohol Disclaimer - Confirm you are at least 21 to order.
Yes, I am 21 or older.
No, I am not 21 or older.
The Nick Miller: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Nick Miller: Recipient(s) Address
Please list the local address for your package recipient(s).
The Schmidt & Cece Couple's Package
*
Price:
$60.00
Quantity:
Amount of Schmidt & Cece packages you would like to order.
The Schmidt & Cece Package: Recipient Names
*
The Schmidt & Cece: Drink selection.
*
Alcoholic package.
Non-alcoholic package.
The Schmidt & Cece: Alcohol Disclaimer - Confirm you are at least 21 to order.
*
Yes, I am 21 or older.
No, I am not 21 or older.
The Schmidt & Cece: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Schmidt & Cece: Recipient(s) Address
Please list the local address for your package recipient(s).
The Claire Dunphy Package
*
Price:
$30.00
Quantity:
Amount of Claire Dunphy packages you would like to order.
The Claire Dunphy: Recipient Name(s)
*
The Claire Dunphy: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Claire Dunphy: Recipient(s) Address
Please list the local address for your package recipient(s).
The Cameron Tucker Package
*
Price:
$30.00
Quantity:
Amount of Cameron Tucker packages you would like to order.
The Cameron Tucker: Recipient Name(s)
*
The Cameron Tucker: Alcohol Disclaimer - Confirm you are at least 21 to order.
*
Yes, I am 21 or older.
No, I am not 21 or older.
This package contains alcohol.
The Cameron Tucker: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Cameron Tucker: Recipient(s) Address
Please list the local address for your package recipient(s).
The Gloria Delgado-Pritchett Package
*
Price:
$30.00
Quantity:
Amount of Gloria Delgado-Pritchett packages you would like to order.
The Gloria Delgado-Pritchett: Recipient Name(s)
*
The Gloria Delgado-Pritchett: Alcohol Disclaimer - Confirm you are at least 21 to order.
*
Yes, I am 21 or older.
No, I am not 21 or older.
This package contains alcohol.
The Gloria Delgado-Pritechett: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Gloria Delgado-Pritchett: Recipient(s) Address
Please list the local address for your package recipient(s).
The Cher Package
*
Price:
$30.00
Quantity:
Amount of Cher packages you would like to order.
The Cher: Recipient Name(s)
*
The Cher: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Cher: Recipient(s) Address
Please list the local address for your package recipient(s).
The DionnePackage
*
Price:
$30.00
Quantity:
Amount of Dionne packages you would like to order.
The Dionne: Recipient Name(s)
*
The Dionne: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Dionne: Recipient(s) Address
Please list the local address for your package recipient(s).
The Wednesday Package
*
Price:
$30.00
Quantity:
Amount of Wednesday packages you would like to order.
The Wednesday: Recipient Name(s)
*
The Wednesday: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Wednesday: Recipient(s) Address
Please list the local address for your package recipient(s).
The Enid Sinclair Package
*
Price:
$30.00
Quantity:
Amount of Enid Sinclair packages you would like to order.
The Enid Sinclair: Recipient Name(s)
*
The Enid Sinclair: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Enid Sinclair: Recipient(s) Address
Please list the local address for your package recipient(s).
The Thing Package
*
Price:
$30.00
Quantity:
Amount of Thing packages you would like to order.
The Thing: Recipient Name(s)
*
The Thing: How do you want your recipient to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
The Thing: Recipient(s) Address
Please list the local address for your package recipient(s).
Kids Package
*
Price:
$15.00
Quantity:
Number of Kids Packs you would like to order. ***Ages 1-4 still available; ages 5-12 SOLD OUT***
Kids Pack: List your kid(s) name and age.
*
Kids Package: How do you want your recipient(s) to receive the package?
*
Delivery: We will provide contactless delivery.
Pickup: You can pickup your package(s) at ACPL on Monday, Feb. 13.
Delivery is available within a certain area. Check our map at: https://foundation.acplwy.org/blind-date-with-a-book/delivery-map-area.
Kids Pack: Recipient Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Please fill in the address if you selected Delivery. If you selected Pickup, we will contact you to coordinate a pickup time.
Anything else we need to know?
Questions?
Contact the Foundation office at 307-460-2481 or cwhite@acplwy.org.
Email Us
(307) 460-2481
Donate
