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*Contact Name
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*E-mail
Address
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*Contact Phone Number
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Second Phone Number
(party phone number)
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*Party Address
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*Party City
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Party Zip Code
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Major
Cross Streets
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*Party Date and Time
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Party Rating
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Party Type
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Guest of Honor
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Number of Guests
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Crowd Type
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*Number of Entertainers
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Entertainer Choice One
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Entertainer Choice Two
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Entertainer Choice Three
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Entertainer Choice Four
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Costume Choice One
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Costume Choice Two
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Is
your party a surprise
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Y
N
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*Payment Type
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Card Type
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Name as appears on card
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Card Number
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Card Expiration Date
mm/yy
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How did you hear about
Explicit Strippers?
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Questions, Comments or Requests
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