YOUR FIRST NAME:
YOUR LAST NAME:
YOUR EMAIL ADDRESS:
YOUR DAYTIME PHONE NUMBER (please include dashes): (
YOUR EVENING PHONE NUMBER (please include dashes):
YOUR MOBILE PHONE NUMBER (please include dashes)
COMPANY NAME (where applicable):
IF REQUESTED, YOUR FAX NUMBER:
FIRST NAME OF RECIPIENT:
LAST NAME OF RECIPIENT:
OCCASION:
DELIVERY DATE:
TIME WINDOW FOR DELIVERY (must be a minimum of 30 minutes):
CAN YOU PROVIDE A CONTACT PERSON FOR THIS DELIVERY? (TYPE NAME HERE):
CONTACT PERSON'S PHONE NUMBER: (
ADDRESS FOR DELIVERY:
PLEASE PROVIDE DRIVING DIRECTIONS FROM RDU (NO MAPQUEST, BUT IN YOUR OWN WORDS...MAKE SURE TO INCLUDE DISTANCE BETWEEN EVERY TURN!):
HUMOROUS, ROMANTIC, OTHER (please define):
DISPOSABLE CAMERA FOR "CAPTURING" THE MOMENT? (to be either left with recipient, or mailed to you afterwards):
DO YOU WISH TO ADD ROSES?
PAPER-WRAPPED, OR IN A VASE?
SPECIFY HOW MANY, AND 1st/2nd COLOR CHOICE:
SONG CHOICE:
ARTIST (WHERE APPLICABLE):
RECIPIENT'S FAVORITE MUSIC GENRE:
PERSONALIZED SONG INFO (PLEASE PROVIDE AT LEAST SIX DETAILS. You are not limited to the suggestions below, so feel free to add your own):
NICKNAMES:
FAVORITES (junk foods/drinks, schools, sports, hobbies, people, politics, places...
DISLIKES AND IRRITANTS:
LOVE INTEREST:
MEMORABLE MOMENTS (FUNNY OR EMBARRASING):
ADDITIONAL COMMENTS (please make sure you have included your email address in the field above):
PLEASE ENTER FEE QUOTE YOU RECEIVED FROM OUR OFFICE FOR THIS DELIVERY
PAYMENT METHOD (CASH, CHECK, MASTERCARD OR VISA):
CREDIT CARD NUMBER (A $5.00 FEE IS ADDED TO ALL CREDIT CARD SALES):
EXPIRATION DATE:
NAME AS IT APPEARS ON CREDIT CARD:
Your charged total will appear on your statement as from LIFE OF THE PARTY, thanks!
WHAT SENTIMENT WOULD YOU LIKE TO BE PRINTED ON THE ACCOMPANYING TELEGRAM? (Like a greeting card that recipient keeps):
Our office will confirm receipt of your form as soon as we receive it.