"Let's Plan Questionnaire"
Date Night Planning Services
Email address *
Full Name: *
Your answer
Phone #: *
Your answer
Preferred method of contact:
What is the best time to contact you? *
Discretion Is Our Middle Name!
We'll contact you when you are FREE! It is absolutely safe! No voicemails or audio messages. If we miss you, we'll send you an email to schedule new time or you can call us during our hours of operation at 754-229-9855.
Let's Plan The Details...
What Date Night Package are you interested in purchasing? *
Required
When was your last date night?
MM
/
DD
/
YYYY
What is the budget for your romantic rendezvous? *
Your answer
Proposed date for romantic rendezvous? *
MM
/
DD
/
YYYY
Proposed Time: *
Time
:
Location: *
Let's Get To Know Your Significant Other!
Please take a moment to answer the questions below, answering these questions will allow us the opportunity to personalize your package.
Significant Other's Name: *
Your answer
Significant Other's Birthday: *
Your answer
Significant Other's E-Mail: *
Your answer
What is your Significant Other's age range? *
Music Preference: *
What are some of your Significant Other's favorite things? (i.e.- favorite flower, color, food, restaurant, activity, etc.) *
Your answer
What are some of your Significant Other's dislikes or things that are off limits? *
Your answer
Please list any dietary restrictions. *
Your answer
What are some things/activities your Significant Other enjoys? (Playing sports, reading, crafting, swimming, walking) *
Your answer
How would you describe your significant other? (Creative, Introvert, Extrovert, Nature Lover, Etc.) *
Your answer
What is your Significant Other's Love Language? *
What is your Significant Other's idea of a "Perfect Date" *
Your answer
Now, Let's Get To Know You!
When is YOUR Birthday? *
Your answer
Your Music Preference: *
What are some of YOUR favorite things? (i.e.- favorite flower, color, food, restaurant, activity, etc.) *
Your answer
What are some things/activities YOU enjoy? (Playing sports, reading, crafting, swimming, walk) *
Your answer
How would you describe YOURSELF? (Creative, Introvert, Extrovert, Nature Lover, Etc.) *
Your answer
What is YOUR Love Language? *
What is YOUR idea of a "Perfect Date" *
Your answer
Please list any dietary restrictions. *
Your answer
Miscellaneous Information:
*Non-Refundable $100.00 Deposit MUST be paid to secure vendor(s) for proposed Date Night Event *

*Remainder of Balance MUST be paid within 5 Days of Event*

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