Name: First: Last: Address: Street: City: State: Home Phone: Area Code: Number: Business Phone: Area Code: Number: Extension: Cell Phone: Area Code: Number: Beeper/Pager: Number: Email Address: Party Information: Not all dancers are available all days and times - please be specific to your needs and we will accomidate you to the best of our ability. Party/Event Location: Number of Guests: Budget: Number of entertainers: select below 1 2 3 4 5 6 7 8 9 10 more Party/Event Type: select below Bachelor Party Birthday Party Divorce Party Holiday Party Office Party Private Party Super Bowl Promotional Event other Date of Party/Event: Month select month of appointment January Febuary March April May June July August September October November December Date: select date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Start Time: select hour 1 2 3 4 5 6 7 8 9 10 11 12 select AM PM End time: select hour 1 2 3 4 5 6 7 8 9 10 11 12 select AM PM Additional Requests or Comments: Should we call at certain times? Are you looking for a ladies for a special need? Please use this area to assisit us in providing you with the best possible service:
