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GIFT REQUEST FORM
PLEASE PROVIDE YOUR EMAIL ADDRESS
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Email
*
Your email
YOUR NAME
*
Your answer
YOUR PHONE NUMBER
*
Your answer
GIFT CHOICE
*
CHOOSE 1 OF THE FOLLOWING (PRICES DO NOT INCLUDE SHIPPING OR DELIVERY)
Simply Larry (Starts at $75)
Good Life Larry (Starts at $90)
Over the Top Larry (Starts at $175)
Taste of Wisconsin (Starts at $60)
Custom
IF CUSTOM OR MODIFIED VERSION OF ABOVE CHOICES, PLEASE INCLUDE WHAT YOU WOULD LIKE BELOW PLUS DOLLAR AMOUNT OF GIFT AND SHIPPING/DELIVERY IF APPLICABLE
Your answer
RECIPIENT FULL NAME
*
Your answer
RECIPIENT ADDRESS
*
Your answer
WOULD YOU LIKE US TO ENCLOSE A CARD?
*
Yes
No
IF ENCLOSING A CARD, PLEASE WRITE WHAT YOU WOULD LIKE IT TO SAY
Your answer
WOULD YOU LIKE TO PICK UP THE GIFT, OR HAVE US SHIP VIA UPS, OR DELIVER IT?
*
PICK UP
SHIP VIA UPS
DELIVER VIA OUR DRIVER LOCALLY (LIMITED AREA)
WHEN WOULD YOU LIKE TO PICKUP OR SHIP/DELIVER
*
MM
/
DD
/
YYYY
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