Service Request
Coqui-Grams Entertainment Edif. Darlington Oficina 1106 Rio Piedras PR 00925
Tel. 787-751-8700 / 787-766-2770


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Client's Name-  Date of Request-


Postal Address-


Residential Address-


Work Phone.-   House Phone.-   Other -


Client's Date of birth(do not include the year) -


How did you know about Coqui-Grams?-   e-mail -


Adressee -  Date of the activity -


Activity Address -


Activity phone number -  Time-


Occasion -  Character-


Payement method: Complete Charge Charge Deposit Only- *Visa-MC-AX-

Credit Card Number -


Expiration Date -   Bank-


Name of Card Owner -


Press to sends us this information


Importatnt Notice:
Filling this request does not guarantee that the wished service is available.  You should first call our phone numbers (787) 751-8700, 766-2770 to  schedule our services.  After the service has been coordinated, then you may fill this order.
Please visit our contract page.