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Gift Shopping Companion Request Form

 

Purchaser Information

Title: First Name: Last Name:

E-Mail Address: Phone Number:

Schedule

What day would you like to schedule an appointment? (Please note appointments are only available on Saturdays from 10:00am to 4:00pm and Sundays from 11:00am to 4:00pm in one, two, thee, and four hour increments)

Date (Please provide three potential shopping dates)

Trip Duration 1hr   2hr   3hr   4hr

Gift Recipient Profile

Female Male

Recipient's Relationship to Purchaser:

Recipient's Age:

Recipient's Town/City and State:

Gift Occasion:   

How much do you want to spend?

Recipient's Favorite Color:

List the last three gifts the recipient has received from you:

Recipient's Style/Personality:

Recipient's Hobbies and Interests: (Select all that apply)

Gardening/Nature Eco-Conscious Art/Photography Animals

Jewelry Clothing/Shoes Fragrances Literature

Travel Dolls Electronics/Gadgets Household Electronics

Cosmetics Music Sports Cooking/Entertaining

Arts and Crafts Toys Other:


Provide any other relevant information regarding the recipient:

Include information relating to the recipient's tastes and interests. Note gifts recipient has expressed liking or disliking.

What do you want to convey with this gift:

How did you hear about us?   

I Agree (By clicking "I agree" you indicate that you accept and consent to our Terms and Conditions )

No Spam code:

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