Name:

Address:

City, State and Zip:

Business Phone:                       EMAIL:

Home Phone:                           Cell:

Your preferred way to be contacted:

Phone: (W) or (H) Cell: Email: Postcard or Letter in Mail:

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Spouse or Significant Other's Birth Date: Anniversary Date:

Favorite Color Rose or Type of Flower:

Other Special Dates to Remember:

Parent's Birthday (M) (D) Anniversary:

Children's Names and Birthdays:

Secretary's Name and Birthday or Work Anniversary:

Business Partner Birthday or Company anniversary:

Any other Person or Special Date you would like to remember:

Would you like to be notified of any special last minute cruise offers (within a month)?

Would you like to be provided with information about jewelry items?

We have a personal friend in the jewelry business. If you let us know what you are looking for such as diamond rings, Rolex watches, diamond tennis bracelets, etc. we can let you know what is available and either bring it to you for perusal or let you contact the jeweler direct, with your permission.

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Forget-Me-Not Occasions will contact you a month prior to any special date unless you specify otherwise, except for cruises. ** We will also contact you again either two weeks or a week prior as a friendly reminder. Please specify your preference.