Name:

    

Surname:

    

E-Mail:

    

Telephone nr:

(W)   
  (H)
 
  (C)  

Function:
(too ensure the same style dress don’t go out to the same event)

  
Please select one:    

Code:

    
Description:    

Colour:

    

Category:

    
       

To Rental

     

Rental Date:
(Actual Date of event)

  
            YYYY/ MM / DD
  

Return Date:

  
            YYYY/ MM / DD 		  

Extra Days ( R50 per day extra)

      
       

To Order: (different colour &or Size?)

    
Colour?
    
Size?
    
       

Group Rental:

  min 5 dresses 30%discount  

Group Booking Codes:
(Please supply the codes in the textbox )









    
Special Requests or other enquiries: