Please provide the following information:

Name
Organization
Street Address
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
Event Information:	Wedding School Mitzvah Anniversary Reunion Birthday Other Special Event
Enter the date of Event :	-- dd/mm/yy
Approximate number of guests?
Location of event:
Where did you hear about the Party Company?:	The One Book Ameritech Phone Book Referral Bridal Show Direct Mail Search Engine, Please Specify--> Web Site, Please Specify--> If Other, Please Specify-->
Would you like a price quote?	Yes No
If yes, for which DJ / Entertainment Packages?:
Additional Comments or Questions?