Please
fill in all fields marked with a
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| Deliver
To |
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Delivery
Name 1
(Include First & Surname) |
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Delivery
Name 2 |
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Occasion: |
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If 'Other' please
specify |
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Age/Years |
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Delivery Details |
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Delivery Date: |
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Delivery Day |
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Delivery Time |
Between:
and
(2 hr Span Required, if different extra charges may
apply) |
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Delivery /Venue
Name |
and |
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Delivery /Venue Address: |
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Delivery Suburb |
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Delivery State |
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Venue Phone No
(include area code) |
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Booking
Name at
Restaurant |
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Contact |
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Mobile/Cell of Contact |
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No.
of People attending
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approx.
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| Orderer's
Details |
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Order Name |
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Relationship to recipient |
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Phone No (Incl Area code) |
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Fax
No |
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Mobile
No |
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Email |
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Order Address |
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How did you find us? |
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By
who |
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| Package
Details |
Who's
the Nerd at your Party? --->more?
If you
can imagine combining Mr Bean and Austin Powers together
this will give you a pretty good picture of Eugene from
Nerd-a-Gram. EUGENE, Is a very Retro character and quite
stylish too!
His purpose of being is that he pretends to know the guest
of honour (your victim) from a place they hang out at or
are familiar with.
So that when he arrives at the party/venue he will call
the recipient from a distance away by their first and
surname, and this is only where the fun starts! This
RETRO guy is in style!
* Indicate
the "Nerd-a-Gram Singing Telegram" Package you
want by selecting package 1 or 2.
Then complete the details directly below the chosen
package:
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PACKAGE
1
Original
Nerd Singing Telegram |
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PACKAGE
2
Nerd
Character Courier |
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PACKAGE
3
Nerd
- Corporate or Functions
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"The Memories last Forever...." |
"SHORT, SWEET & SLIGHTLY OFF-BEAT!" |
"Tell
us what you want?" |
Included
in this package is:
The
Nerd Singing Telegram
(arrives
for the recipient with choreographed little skit on how
he knows them)
 A
Personalised Poem
presented on a coloured scroll
A Bouquet
of 6 Helium Balloons
Nerd
Glasses
(with
their name imprinted in Gold)
Ball'n'Chain
(For Hen's/Girls Night Only replaces Glasses)
The
Official Nerd Certificate
Your Personal Message Card
Party Treats
Chose
one (1) Gift from the following:
Chose
one (1) poem option:
Would
you like additional gifts or services added to your package?
|
Included
in this package is:
The
Nerd Character Courier
(arrives
to deliver a song and a message)
Sings
a Song appropriate for the
occasion
Reads
your Message Card aloud!
Stuff
to ADD
for more Pizzazz
Helium Filled Balloons
Autograph Bear
Nerd
Glasses
Teddy
Bear
Love Cuffs
Chocolates
Champagne
Ball 'n' Chain
-->View
Gift Pics
For
ONLY an extra $35 each add any of the above gifts to
this Elvis Character Courier Package
EXTRA
SONGS are $15 each
Chose
one (1) poem option:
Note:
Friday
5pm to Monday 8am incurs a $15 fee
|
Are
you wanting,
A Stage/Floor Show
A Stage/Floor Show and you are the Club or Hotel
co-ordinator
Other -
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Select
an event type
Corporate Function/Occasion
Private Occasion |
Select
an Event type
Corporate Function/Occasion
Private Occasion |
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Message on Card to Read:
(Up
to 50 words only)
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Extra Details:
(Please Supply
us with a story on "HOW" Eugene (Nerd-a-Gram)
would really know the Recipient! Please supply us with REAL
NAMES, REAL TIME FRAMES etc...and any other information
which may be useful to the performer)
Note: NOT ORIGINAL POEM INFO - please email information
for poem to POET) |
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For Hen's
OR Buck's Nights Only
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Fiancé's
First Name |
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Wedding
Date |
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| Payment
Details |
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Credit Card type:
(Major cards accepted) |
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Expiration Date: |
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Cardholder's Name
(as it appears on the card) |
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Credit Card number: |
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Cardholder's street address |
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Cardholder's City |
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Cardholder's State/Province |
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Cardholder's Zip/Post
Code |
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Cardholder's Country |
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Cardholder's Telephone |
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Credit card verification number |
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If
M/CARD or VISA insert 3 digit ID on reverse of card |
If
AMEX insert the 4 digit ID listed on the front of your
card |
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I
would like to pay on the above credit card |
The
Full Cost Amount |
$95
Deposit - Then the remaining Balance paid as CashOnDelivery
to the Performer |
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*
You MUST SIGN |
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