Please
fill in all fields marked with a
Deliver
To
Delivery
Name 1
(Include First & Surname)
Delivery
Name 2
Occasion:
Birthday
Anniversary
Buck's Night
Congratulations
Corprate Event
End of Financial Year
Engagment
Farewell
Farewell - Maternity Leave
Farewell - New Job/Postion
Farewell - Retirement
Grand Opening Sale
Hen's Night
I Love You
Kitchen Tea
Just Because
Make Up/Break Up
Product Launch
Retirement
Sprooking
Other
Marriage Proposal
Select an Occasion
If 'Other' please
specify
Age/Years
Delivery Details
Delivery Date:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Jan
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec
2012
2013
2014
Delivery Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Delivery Time
Between:
PM
AM
and
PM
AM
(2 hr Span Required, if different extra charges may
apply)
Delivery /Venue
Name
and
---->Select Venue Type
Home
Restaurant
Office/Work Place
Factory/Work Place
Hotel/Bar
Motel
Function Centre
Club Function Room
Private Function Hall
Park
Beach
Other
Delivery /Venue Address:
Delivery Suburb
Delivery State
---->Select State
NSW
Victoria
Other
Venue Phone No
(include area code)
Booking
Name at
Restaurant
Contact
Mobile/Cell of Contact
No.
of People attending
approx.
Orderer's
Details
Order Name
Relationship to recipient
Phone No (Incl Area code)
Fax
No
Mobile
No
Email
*Please
check your email is correct!
Order Address
How did you find us?
---->Select one
Regular Customer
Google
MSN or NineMSN
A Friend Refered you
Received a Service from us
Highly Reccommended
Yellow Pages.com.au
whitepages.com.au
Sensis
AOL
Other
By
who
Package
Details
Singing
Gorilla Gram bursts into the scene, To lay your victims
quirks clean. Everyone can join in to sing a song, As your
victim apes about to play along. After the embarrassment
has come to an end, The Gorilla will read out the message
you want to send --->more?
A Telegram that any other gift can't give. For that
event where you want the recipient/s to never forget this
occasion...and they won't!
*
Indicate the "Gorilla Singing Telegram" Package you want by
selecting package 1, 2 or 3.
Then complete the details directly below the chosen package:
PACKAGE
1
Gorilla
Singing Telegrams
PACKAGE
2
Gorilla
Delivery
PACKAGE
3
Bongo
Gram
"Let's Go Bananas"
"Go
on, show how wild you really are!"
"Put
them to the test!"
Included
in this package is:
The
Gorilla Singing Telegram
( The
Big
Black Hairy African Accented Singing Gorilla Gram
entering the venue to a traditional Singing
Telegram with his bongos!)
A
Hand of Real Banana's or a Soft Toy Mini-Me
Gorilla
A Bouquet of
6 Helium Balloons
Party Treats
for
the Guests
Gorilla
Challenges - To
see if they are up to all the challenges that now
lays ahead in life.
Your Personal Message Card
- Hidden
in a Balloon!
Chose
one (1) poem option:
Would
you like additional gifts or services added to your package?
Autograph Bear - $16.50
Ball 'n' Chain (Suit Hen's)- $16
Balloons - 6 Helium Filled - $19.50
Balloon - Foil Helium - $16.50
Hand of Real Banannas - $ 16.50
Champagne - $16.50
Champagne - Other pls specify
Chocolates - $16.50
Elvis Glasses - $20
Gorilla - Black - 25cm - $16.50
Gorilla - White - 25cm - $16.50
Jelly Beans - $15
Love Cuffs - $16.50
Poem - Extra Copy - $ 16.50
Poem - Transcribe yours - $33
Select from the following:
OTHER - Please Specify--->
Included
in this package is:
The
Gorilla Character Courier
(The
Big Black Hairy Gorilla makes a grand entrance when he
arrives
for the recipient )
Sings
a Song appropriate for the
occasion
---->Selection a Song Now
Birthday ---------- Happy Birthday Chorus
Anniversary ------ Happy Anniversary Baby
Wedding ------ Going to the Chapel
Hen's Night ------ Going to the Chapel
Buck's Night------ Going to the Chapel
Love ---- That's Amore
Love ---- Love, Love Me Do
Love ---- Hunka Burning Love
Love ---- Wild Thing
Love ----You are So Beautiful
Farewell ---- So long, Farwell
Get Well ---- You are my Sunshine
Some where over the Rainbow
Always look on the Bright side of Life
Christmas - Jingle Bells
Christmas - Wish you a Merry Christmas
Christmas - Rudolph the Reindeer
Mother's Day - You are So Beautiful, to me
Father's Day - To be Advised
Valentine's Day - You are So Beautiful, to me
Valentine's Day - Wild Thing
Valentine's Day - Hunka Burning Love
Australian Anthem
Reads
your Message Card aloud!
AD D
ON'S to go wild with
Helium Filled Balloons
Autograph Bear
Elvis
Glasses
Love Cuffs
Champagne
Ball 'n' Chain
-->View
Gift Pics
For
ONLY an extra $35 each add any of the above gifts to
this Gorilla Character Courier Package
EXTRA
SONGS are $15 each
---->Song Selection
Birthday ---------- Happy Birthday Chorus
Anniversary ------ Happy Anniversary Baby
Wedding ------ Going to the Chapel
Hen's Night ------ Going to the Chapel
Buck's Night------ Going to the Chapel
Love ---- That's Amore
Love ---- Love, Love Me Do
Love ---- Hunka Burning Love
Love ---- Wild Thing
Love ----You are So Beautiful
Farewell ---- So long, Farwell
Get Well ---- You are my Sunshine
Some where over the Rainbow
Always look on the Bright side of Life
Christmas - Jingle Bells
Christmas - Wish you a Merry Christmas
Christmas - Rudolph the Reindeer
Mother's Day - You are So Beautiful, to me
Father's Day - To be Advised
Valentine's Day - You are So Beautiful, to me
Valentine's Day - Wild Thing
Valentine's Day - Hunka Burning Love
Australian Anthem
Chose
one (1) poem option:
Note :
Friday
5pm to Monday 8am incurs a $15 fee
Are
you wanting,
A Stage/Floor Show
A Stage/Floor Show
and you are the
Club or Hotel
co-ordinator
Other -
Select
an event type
Corporate Function/Occasion
Private Occasion
Select
an Event type
Corporate Function/Occasion
Private Occasion
Message on Card to Read:
(Up
to 50 words only)
E xtra Details:
(Optional: Information which may be useful to the
performer NOT ORIGINAL POEM INFO - please email information
for poem to POET )
For Hen's
OR Buck's Nights Only
Fiancé's
First Name
Wedding
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
0
1
2
3
4
5
6
7
8
9
10
11
12
0
20??
2011
2012
2013
Payment
Details
Credit Card type:
(Major cards accepted)
American Express
Diners
VISA
Mastercard
Bankcard
Expiry Date:
01
02
03
04
05
06
07
08
09
10
11
12
??
2012
2013
2014
2015
2016
??
Cardholder's Name
(as it appears on the card)
Credit Card number:
Cardholder's street address
Cardholder's City
Cardholder's State/Province
Cardholder's Zip/Post
Code
Cardholder's Country
Australia
United States
Afghanistan
Albania
Algeria
American Somoa
Andorra
Angola
Anguilla
Antartica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Islands
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Islands
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of
Cook Island
Costa Rica
Cote Divoire
Croatia
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Egypt
El Salvador
Equador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Federated States of Micronesia
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Macdonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia (Rep. of Fmr Yugoslav)
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Metropolitan France
Mexico
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Nieu
Niger
Nigeria
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
S. Georgia and S. Sandwich Islands
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St Helena
St Kitts and Nevis
St Lucia
St Pierre and Miquelon
St Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands - British
Virgin Islands - US
Wallis and Futuna Islands
Western Sahura
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Cardholder's Telephone
Australia (+ 61)
Afghanistan (+ 093)
Albania (+ 355)
Algeria (+ 213)
American Somoa (+ 684)
Andorra (+ 376)
Angola (+ 244)
Anguilla (+ 001)
Antartica (+ 672)
Antigua and Barbuda (+ 001)
Argentina (+ 054)
Armenia (+ 374)
Aruba (+ 297)
Australia (+ 061)
Austria (+ 043)
Azerbaijan (+ 994)
Bahamas (+ 001)
Bahrain (+ 973)
Bangladesh (+ 880)
Barbados (+ 001)
Belarus (+ 375)
Belgium (+ 032)
Belize (+ 501)
Benin (+ 229)
Bermuda (+ 001)
Bhutan (+ 975)
Bolivia (+ 591)
Bosnia and Herzegovina (+ 387)
Botswana (+ 267)
Bouvet Islands (+ 047)
Brazil (+ 055)
British Indian Ocean Territory (+
246)
Brunei (+ 673)
Bulgaria (+ 359)
Burkina Faso (+ 226)
Burundi (+ 257)
Cambodia (+ 855)
Cameroon (+ 237)
Canada (+ 001)
Cape Verde (+ 238)
Cayman Islands (+ 001)
Central African Republic (+ 236)
Chad (+ 235)
Chile (+ 056)
China (+ 086)
Christmas Islands (+ 618)
Cocos (Keeling) Islands (+ 061)
Colombia (+ 057)
Comoros (+ 269)
Congo (+ 242)
Congo, Democratic Republic of (+
243)
Cook Island (+ 682)
Costa Rica (+ 506)
Cote Divoire (+ 225)
Croatia (+ 385)
Cyprus (+ 357)
Czech Republic (+ 420)
Denmark (+ 045)
Djibouti (+ 253)
Dominica (+ 001)
Dominican Republic (+ 001)
East Timor (+ 670)
Egypt (+ 020)
El Salvador (+ 503)
Equador (+ 593)
Equatorial Guinea (+ 240)
Eritrea (+ 291)
Estonia (+ 372)
Ethiopia (+ 251)
Falkland Islands (+ 500)
Faroe Islands (+ 298)
Federated States of Micronesia (+
691)
Fiji (+ 679)
Finland (+ 358)
France (+ 033)
French Guiana (+ 594)
French Polynesia (+ 689)
French Southern Territories (+ 596)
Gabon (+ 241)
Gambia (+ 220)
Georgia (+ 995)
Germany (+ 049)
Ghana (+ 233)
Gibraltar (+ 350)
Greece (+ 030)
Greenland (+ 299)
Grenada (+ 001)
Guadeloupe (+ 590)
Guam (+ 001)
Guatemala (+ 502)
Guinea (+ 224)
Guinea-Bissau (+ 245)
Guyana (+ 592)
Haiti (+ 509)
Heard and Macdonald Islands (+ 061)
Honduras (+ 504)
Hong Kong (+ 852)
Hungary (+ 036)
Iceland (+ 354)
India (+ 091)
Indonesia (+ 062)
Iran (+ 098)
Ireland (+ 353)
Israel (+ 972)
Italy (+ 039)
Jamaica (+ 001)
Japan (+ 081)
Jordan (+ 962)
Kazakhstan (+ 007)
Kenya (+ 254)
Kiribati (+ 686)
Korea, North (+ 850)
Korea, South (+ 082)
Kuwait (+ 965)
Kyrgyzstan (+ 996)
Laos (+ 856)
Latvia (+ 371)
Lebanon (+ 961)
Lesotho (+ 266)
Liberia (+ 231)
Liechtenstein (+ 423)
Lithuania (+ 370)
Luxembourg (+ 352)
Macau (+ 853)
Macedonia (Rep. of Fmr Yugoslav) (+
381)
Madagascar (+ 261)
Malawi (+ 265)
Malaysia (+ 060)
Maldives (+ 960)
Mali (+ 269)
Malta (+ 356)
Marshall Islands (+ 692)
Martinique (+ 596)
Mauritania (+ 222)
Mauritius (+ 230)
Mayotte (+ 269)
Metropolitan France (+ 033)
Mexico (+ 052)
Moldova (+ 373)
Monaco (+ 377)
Mongolia (+ 976)
Montserrat (+ 001)
Morocco (+ 212)
Mozambique (+ 258)
Myanmar (+ 095)
Namibia (+ 264)
Nauru (+ 674)
Nepal (+ 977)
Netherlands (+ 031)
Netherlands Antilles (+ 599)
New Caledonia (+ 687)
New Zealand (+ 064)
Nicaragua (+ 505)
Nieu (+ 683)
Niger (+ 227)
Nigeria (+ 234)
Norfolk Island (+ 672)
Northern Mariana Islands (+ 001)
Norway (+ 047)
Oman (+ 968)
Pakistan (+ 092)
Palau (+ 680)
Palestinian Territory, Occupied (+
970)
Panama (+ 507)
Papua New Guinea (+ 675)
Paraguay (+ 595)
Peru (+ 051)
Philippines (+ 063)
Pitcairn (+ 872)
Poland (+ 048)
Portugal (+ 351)
Puerto Rico (+ 001)
Qatar (+ 974)
Reunion (+ 262)
Romania (+ 040)
Russia (+ 007)
Rwanda (+ 250)
S. Georgia and S. Sandwich Islands
(+ 995)
Samoa (+ 684)
San Marino (+ 378)
Sao Tome and Principe (+ 239)
Saudi Arabia (+ 966)
Senegal (+ 221)
Seychelles (+ 248)
Sierra Leone (+ 232)
Singapore (+ 065)
Slovakia (+ 421)
Slovenia (+ 386)
Solomon Islands (+ 677)
Somalia (+ 252)
South Africa (+ 027)
Spain (+ 034)
Sri Lanka (+ 094)
St Helena (+ 290)
St Kitts and Nevis (+ 001)
St Lucia (+ 001)
St Pierre and Miquelon (+ 508)
St Vincent and the Grenadines (+ 001)
Sudan (+ 249)
Suriname (+ 597)
Svalbard and Jan Mayen Islands (+
047)
Swaziland (+ 268)
Sweden (+ 046)
Switzerland (+ 041)
Syria (+ 963)
Taiwan (+ 886)
Tajikistan (+ 992)
Tanzania (+ 255)
Thailand (+ 066)
Togo (+ 228)
Tokelau (+ 690)
Tonga (+ 676)
Trinidad and Tobago (+ 001)
Tunisia (+ 216)
Turkey (+ 090)
Turkmenistan (+ 993)
Turks and Caicos Islands (+ 001)
Tuvalu (+ 688)
Uganda (+ 256)
Ukraine (+ 380)
United Arab Emirates (+ 971)
United Kingdom (+ 044)
United States Minor Outlying Islands
(+ 001)
Uruguay (+ 598)
Uzbekistan (+ 998)
Vanuatu (+ 678)
Vatican City (+ 039)
Venezuela (+ 058)
Vietnam (+ 084)
Virgin Islands - British (+ 001)
Virgin Islands - US (+ 340)
Wallis and Futuna Islands (+ 681)
Western Sahura (+ 212)
Yemen (+ 967)
Yugoslavia (+ 381)
Zaire (+ 243)
Zambia (+ 260)
Zimbabwe (+ 263)
Credit card verification number
If
M/CARD or VISA insert 3 digit ID on reverse of card
If
AMEX insert the 4 digit ID listed on the front of your
card
I
would like to pay on the above credit card
The
Full Cost Amount
$95
Deposit - Then the remaining Balance paid as C ashO nD elivery
to the Performer
*
You MUST SIGN