Perfect Dates

application form

Please use this application form to apply for an event, workshop or to order our sensational new two sided book How to get the man you want & How to get the woman you want.

On receipt of your Application Form and payment you will be enrolled in an upcoming Perfectdates Event of your choice.As numbers are limited for each event, register now to be part of the Ultimate Dating Experience and have the time of your life meeting lots of new Friends and maybe even the partner of your dreams.

If you do not wish to submit this form electronically, please print it out and post to 22 Pender Street, Thornbury Vic 3071 or fax to 03 9443 7576. If faxing please call Perfectdates on 03 9863 7633 prior to sending your fax.

Alternatively contact us on 03 9863 7633 if you would like us to send or email you a copy of the application form.

All fields need to be completed to submit this form. If you are wishing to purchase the book or CDs and would prefer not to complete the form please call 03 9863 7633. Have a great day!.'

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Please fill in ALL entries in the form that apply to you.
Is this Application for you or for a Friend?	Myself Friend
If this application is a Gift Certificate for a Friend please fill in the Friend's contact details below. Or if this is for you, click here.
My Friend's First Name
My Friend's Last Name
My Friend's Address
My Friend's Suburb
My Friend's Telephone
My Friend's Mobile
My Friend's Email address
And please fill in your own details below.
My First Name
My Last Name
My Address
My Suburb
My Telephone
My Mobile
My Email
Please fill out ALL details below, or fill out your Friend's details if the Application is for a gift. Entries marked with a * are required fields.
Which of the above is the best way to contact you? *
Date of birth *
Sex *	M F
Job *
What type of event do you want to be involved in? *	Heterosexual Gay
Where did you hear about Perfectdates?
Occupation?
Do you have kids?
What do you do with your free time and why? *
How would you describe yourself? *
What are you looking for in a partner? *
What are you most passionate about? *
Do you find meeting new people easy or difficult?*
If you saw someone that you thought was gorgeous would you say 'Hi' or look the other way?*
If attending the How to get the one you want workshop, what do you wish to gain from the workshop? *
Additional Comments -Where did you hear about Perfectdates? And your available dates or times, etc.

repeat customer discounts As a thank you for your continued support, Perfectdates is proud to offer it's repeat Speed Dating customers 30% off your next Speed Date. (Repeat Customer Discounts do not apply to Singles Parties or Workshops.)
registration You can register for more than one event using the same application form, however if you'd like to make a group booking please call 03 9863 7633. Which event would you like to register for:
Perfectdates Speed Dating - Melbourne Australia's Biggest Speed Dating Events with over 100 singles at each event. 22 - 50 with 3 age groups Please note - Due to media commitments with How to get the man you want & How to get the woman you want. No Speed Dating events are currently scheduled.	Speed Dating Non-members $89.00 inc gst
	Speed Dating Repeat Customers $62.00 inc gst
Melbourne - How to get the one you want Workshop. Early Bird Disount - Melbourne 2 day workshop Sat Feb 14th and Sun 15th 2009	Get the One You Want Workshop Early Bird Discount. Book and pay by 31st November 2008 and get $100 off. Pay only: $495.00 inc gst

Melbourne - How to get the one you want Workshop. Melbourne 2 day workshop Sat Feb 14th and Sun 15th 2009 For bookings after 31st November 2008	Get the One You Want Workshop Non-Members: $595.00 inc gst

Sydney - How to get the one you want Workshop. Early Bird Disount - Sydney 2 day workshop Sat Feb 7th and Sun Feb 8th 2009	Get the One You Want Workshop Early Bird Discount. Book and pay by 31st November 2008 and get $100 off. Pay only: $495.00 inc gst

Sydney - How to get the one you want Workshop. Sydney 2 day workshop Sat Feb 7th and Sun Feb 8th 2009 For bookings after 31st November 2008	Get the One You Want Workshop Non-Members: $595.00 inc gst


Pre-Order your copy of the sensational new 2 sided book 'How to get the man you want & How to get the woman you want' Order and Pay for your book before the 30th November 2008 and get your postage to anywhere in Australia free.	Book $29.95 inc gst

I agree in submitting this form that I am single and will represent myself in an honest manner and have read and understood the terms and conditions as listed below.
All credit card information is processed on a secure server with Westpac Bank.

terms and conditions

There is a 2% surcharge on all credit card payments.
You will be contacted with details of upcoming Perfectdates events within five working days of receipt of your application form and payment .
Perfectdates holds no responsibility for the outcome of any relationship that may or may not arise between you and another person that you might meet through a Perfectdates event. You agree not to initiate any claim against Perfectdates resulting from either social or dating activities and agree to hold Perfectdates free from any liability.
Perfectdates takes no responsibility for the activities of its participants, nor of its participants at consequential meetings and reserves the right to refuse entry to any drunken or disorderly person.
The information supplied to Perfectdates will be kept confidential and will not be passed onto a third party without your prior consent.
For security reasons, photo identification will need to be supplied on the night if payment has been made by credit card.
The 'Get the One You Want Singles Party and Book Launch' is a Media Event which is filmed, audio recorded or photographed. By attending this media event you provide permission to both Perfectdates and the media in question to use the material. The footage, images and audio may appear in printed publications, on television or radio, in member newsletters, and on our website.

cancellations

Cancellation within seven days of a confirmed booking- no refunds will be given.
Cancellation received prior to this full refund minus administration fee of $20 given.

contact details
address:	22 Pender Street Thornbury Vic 3071
tel:	03 9863 7633
fax:	03 9443 7576
mob:	0402 517 516
email:	enquiries@perfectdates.com.au
website:	www.perfectdates.com.au
	ABN: 88 214 814 439