RENTACASINO.NET® P.O. Box 335 Newton, MA 02464 T: 617-828-2313 F: 801-457-5221 em: sales@rentacasino.net

Event Inquiry and Information Form

We need to know in as much specific detail all about your planned event to help us properly prepare a quote for your requirements:

Event Type

	Fundraiser - No Dealers, equipment only
	Full Service Casino Night w/Dealers
	Home Party - Equipment only
	Home Party - Equipment & Dealers

Yes No

If your event is a Fundraiser, have you ever conducted one before?

Event Date: MM/DD/YR

Second Choice date: MM/DD/YR

Total # of guests expected:

Budget:

Please check all that apply to your event:

	Casino equipment		Resort/Hotel
	DJ Services		Club,church,synagogue
	Themed Event		Private Home
	Bartending services		Country Club
	Decor		Office building

Please select the quantity of gaming tables you wish to receive a quotation on:

GAME SELECTION	QUANTITY OF EACH
Blackjack (21) table (stand up type)
Blackjack (21) table (sit down type)
Texas Hold Em Tables
Craps Tables
Roulette Tables
Wheel of Fortune (Money Wheel)
Decor	Yes No (none needed)
Accessories: Cards, chips,Shoes etc	Yes No (none needed)
Other (ex. Octogon Poker Table)

Your contact information:

Name:

Street Address:

City, State, Zip Code:

Your email address:

How did you hear about us?

Home Phone:

Comments: Special needs:

Do you need a recommendation for a local caterer? Yes No

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