"D" Dan's Entertainment Agency Request / Contact Form

Customer Request Form

The intent of this form is "to assist You". Provide as little or as much information as you wish... we will receive it via email. If you chose to use the form, there are only three required answers; Your Name, Contact Phone Number and Email Address.

Please provide the following information:

Full Name Required

Title

Organization

Contact Phone Required

E-mail Address Required

Your Website

Select any of the following options that apply:

Match as closely as possible or click Other...

Solo Entertainment Duo Entertainment Bands
Theme Nights, Shows and Tributes Entertainers Weddings & Receptions Disc Jockey / Karaoke

Other Entertainers Other

Please be more Specific and/or Click Here

Close

Would you like us to contact you: by Phone? Yes No

Would you like us to contact you: via email? Yes No

Regarding the Date(s), Times and Location(s) Below;
If Entries reflect your "Best Guess" at this time, Click here
Continue without checking the box, if you are "Sure".

Date / Time [If you have more than one event please type similar details in "Additional Notes" area below]

Enter the Date of your event :

Enter Start & End Time: -

IMPORTANT: Select from either Category A or B and C

A. Check one box below

1. This is an Indoor Event and/or

2.This is an Outdoor Event

B. If this is a Beach Wedding, check the box which applies

1. Reception will be held Indoors or

2. Reception will be held Outdoors

C. An Alternative Indoor Location is Available Yes

otherwise it is presumed a "No"

Location: (Be as specific as possible)

Additional Notes:

If you would like to provide us with more information, here is more space?

OPTIONAL: How did you hear about us?

PLEASE NOTE WHEN YOU CLICK SUBMIT, WE WILL RECEIVE AN EMAIL WITH THE INFO YOU PROVIDED ABOVE. JUST CLICK THE BACK BUTTON ON YOUR BROWSER TO RETURN TO THIS PAGE.

If you have any trouble with this form - feel free to call us toll free at

1-877-332-6410

Thank you for your interest, we will be in touch soon!

Main | Contact Us

Dayn (Left) and "D" Dan (Right)

Family Owned, Founded

in 1986

"D" Dan's Entertainment Agency

Attn: Dayn Lacke

22 Moreno Point Road, Ste. 5

Destin, FL, 32541

Office: (850) 650-6591

Fax: (850) 650-6195

Mobile: (850) 585-3960

Atlanta Line: (770) 451-9863

"D" Dan's Entertainment Agency

Attn: Dan Lacke

323 Woodham Court, Suite 101

Fort Walton Beach, FL 32547

Office: (850) 863-3313

Fax: (850) 650-6195

"D" Dan's Mobile: (850) 585-5960

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Last modified: July 19, 2009

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NOW CELEBRATING OUR 21ST ANNIVERSARY...SINCE 1986 ... "D" Dan's Thanks each and everyone of you that made "D" Dan's Entertainment Agency such a success and we look forward to the next 20 years, Thanks again!

Florida Talent Agency Lic. # TA763.