Platinum Disco & Entertainment
Information Request Form
Date Of Event
First Name
Last Name
Email Address
Home Address
Address Line 2
City *
County *
Post Code *
Telephone
Best Time To Reach You
Guest Count
Setup Time
Start Time
End Time
Event Location (venue)

If your event location is not listed above please fill in the following...


Event Location (Venue)
Event Location (City)
Event Location (County)
Type Of Event
Package Desired
Additional Questions Or Event Details
How did you hear about us?

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