Please
fill in all fields marked with a
 |
| Deliver
To |
 |
Delivery
Name 1
(Include First & Surname) |
|
| |
Delivery
Name 2 |
|
 |
Occasion: |
|
If 'Other' please
specify |
|
| |
Age/Years |
|
|
Delivery Details |
 |
Delivery Date: |
|
 |
Delivery Day |
|
| |
Delivery Time |
Between:
and
(2 hr Span Required, if different extra charges may
apply) |
 |
Delivery /Venue
Name |
and |
 |
Delivery /Venue Address: |
|
 |
Delivery Suburb |
|
Delivery State |
|
| |
Venue Phone No
(include area code) |
|
Booking
Name at
Restaurant |
|
 |
Contact |
|
Mobile/Cell of Contact |
|
| |
No.
of People attending
|
approx.
|
| Orderer's
Details |
 |
Order Name |
|
Relationship to recipient |
|
 |
Phone No (Incl Area code) |
|
Fax
No |
|
 |
Mobile
No |
|
 |
Email |
*Please
check your email is correct! |
 |
Order Address |
|
| |
How did you find us? |
|
By
who |
|
| Package
Details |
Clown Singing
Telegrams™ is..... Oki
Doki the star clown! This bright coloured happy clown will make
anyone's day with surprises and party treats all up his sleeve.
He delivers your personal telegram with song, balloons and gifts
almost anywhere for every occasion.
The Clown
Singing Telegram will arrive at your venue to sing the relevant
occasion song and read out your personal message to your
favourite person on their special occasion day
--->more?
*
Indicate the "Clown Singing Telegram" Package you want by
selecting package 1, 2 or 3.
Then complete the details directly below the chosen package:
|
| |
Message on Card to Read:
(Up
to 50 words only)
|
| |
|
| |
Extra Details:
(Optional: Information which may be useful to the
performer NOT ORIGINAL POEM INFO - please email information
for poem to POET) |
| |
|
| |
For Hen's
OR Buck's Nights Only
|
| |
Fiancé's
First Name |
|
Wedding
Date |
|
| Payment
Details |
| |
Credit Card type:
(Major cards accepted) |
|
Expiration Date: |
|
| |
Cardholder's Name
(as it appears on the card) |
|
Credit Card number: |
|
| |
Cardholder's street address |
|
Cardholder's City |
|
| |
Cardholder's State/Province |
|
Cardholder's Zip/Post
Code |
|
| |
Cardholder's Country |
|
| |
Cardholder's Telephone |
|
|
| |
Credit card verification number |
|
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 |
| |
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 |
| |
|
|
|
|
| |
*
You MUST SIGN |
|
|
|
| |
|
|