This information is to help us determine your needs

to make your event a success.

Please provide the following contact information:

First Name Last Name M.I.

Address City

Zip Home Phone

Cell Phone (optional)

e-Mail

Event Information:

If this is a party, is there a Guest of Honor? Name:

Date of event Time you want to start the Poker game:

Number of Players (10 players per table) :

How much in chips do you want to start with for each player? (500, 1000, 10,000, etc.)

Type of Event:

Corporate Event/Party
Holiday Event
Fundraiser
Private Party
Surprise Birthday Party
Bar/Bat Mitzvah
Other

Do you want us to provide door prizes?

Will the players need any instructions beyond basic tournament rules?

We do not provide chairs for the players.

All information becomes the property of Poker Academy, Inc.
Copyright © 2005Poker Academy, Inc. All rights reserved.
Revised: