Please create and send me a
PERSONALIZED ON-LINE ORDER FORM
based on the following information.
ON-LINE ORDER REQUEST
Warning! Do Not use your RETURN key while filling out this form
(this will automatically Submit before you are ready).
You may use your TAB key.

Name


Company/Organization/School (if applicable)


Position/Title


Mailing Address (Include Suite #)


City


State


Zip Code


Office Phone


Cell Phone


Fax




Email Address


Web Site Address




If Other, Please Describe Your Business


How Did You Come To Find Us?


Referals' Name or Source

Other Things You Should Know About Me

Please BOOK This Date

I Just Need A QUOTE

Please Put A HOLD On This Date

Please CHECK AVAILABILITY For This Date

Please UPDATE This Event

Requested Service(s)
(Check All Appropriate Boxes)

Digital Snapshots - Photo Postcards - 4" x 6"

Digital Snapshots - Key Chains - 2" x 3"

Digital Snapshots - Bookmarks - 2.5" x 7"

Digital Snapshots - Buttons - 3"

Digital Snapshots - Magnets - 2" x 3"

Digital Snapshots - Mouse Pads - 4" x 6"

Digital Snapshots - Mouse Pads - 5" x 7"

Digital Snapshots - Snow Globes - 2" x 3"

Digital Snapshots - 4" x 6"

Digital Snapshots - 5" x 7"

Digital Snapshots - Other
(Please describe in Special Instructions)

Make-Your-Own Music DVD

Become-an Idol Talent Show

Mobile CD Recording Booth

DVD Confessional Booth

Segways Races

Coyote Nail Art

Disc Jockey

Disc Jockey + Big Sound

Disc Jockey + Big Sound + Lights

Disc Jockey + Lights

Karaoke

Karaoke + Lights

Other (Describe in Special Instructions)

My Client/Event Information

(For multiple Dates, Times and/or Venues,
please fill out separate Order Requests.)

Event Client/Company

Contact

Event Date (Sample: January 4, 2004)

Event Theme:
(If you don't find yours here, describe in Special Instructions)

Start Time


End Time


Group Size
people are expected to attend.

Please note that we recommend larger sound systems and/or
multiple product stations for groups larger than 250.

Our Event Will Be Held At The Following Venue

In The Following Location At This Venue

The Venue Street Address Is

In The Following City & State

The Contact and/or Venue Phone Number Is

Special Requests and Instructions

DISCLAMER

FILLING OUT THIS FORM DOES NOT GUARANTEE OUR PRODUCTS
AND/OR SERVICES FOR YOUR REQUESTED DATE AND TIME.

YOU MUST RECEIVE AN EVENT CONFIRMATION FROM
A COYOTE PRODUCTION, INC.™
VIA FAX OR EMAIL TO ENSURE REQUESTED SERVICES.
PLEASE CALL IF YOU HAVE ANY QUESTIONS!

A COYOTE PRODUCTION, INC.™ and it's employees will not accept any
liability for products and services at events for which we have not received
a signed Event Confirmation from the responsible client.

Please Note: All artwork must be approved by the Event Client
at least 7 business days prior to the scheduled event date.




© 1994 - 2007 Coyote Productions
Box 422782, Kissimmee, Florida 34742
Voice: 407.854.0606 Fax: 407.847.5258