| Be sure to reserve your stork, reservations will take priority over any last minute call ins! Please call if you will be needing the stork within the next 2 to 3 days, at 951-852-4917.
Your name: _________________________________________________________________
Street address/city:___________________________________________________________
Your phone number :____________________________________________________________
Your email address:___________________________________________________________
How will you pay (Visa/Mastercard)?:______________________ (Don't include the card number now-we will get it over the phone when the order is placed.)
What is the best way to contact you before delivery if needed?________________________
Name of person(s) stork is for:__________________________________________________
Due date:___________________________________________________________________
Baby's gender (it's a surprise/ boy / girl):____________________________________________
Baby's full name (if you've already decided on one it really helps us out to know it in advance).
_________________________________________________
Delivery address:_____________________________________________________________
Delivery phone number:__________________________________________________________
Is stork rental for 7 or 10 days?: _________________________________________________
Is this a suprise?:_________________ (we won't call deliveree until after stork has been delivered).
Any extra comments:__________________________________________________________
____________________________________________________________________________
Where did you hear about us?___________________________________________________(Yellow Pages, Internet, friend, referral, business displaying our card, Dr.'s office, etc...)
Be sure to pack our contact information in your hospital bag so that you can give us a call when the baby is born to confirm the order. We will need to now the name, date of birth, gender, length and weight of the baby. If this is a gift make sure to call us ASAP with all the information! We will deliver the stork within 1 business day of your confirmed order (in most cases before the mother arrives home with the baby).
Please call in your reservation now to 951-852-4917.
If you would prefer to email this information. Copy and paste the above form into the email window. Fill in answers to the questions and send. Thank you for your order!
|
