*These items must be completed First Name * Surname* Contact Numbers (only one of these has to be filled in)* Home:  Work:    Cell:     Email Address* Gift Required* (this can be made up of several items) Occassion Date Required (dd/mm/yyyy)* Amount of Gift* N B Delivery Charge not included Special Instructions (eg diabetic) Gift Recipient and Address* Message* Method of payment*       Credit Card Direct Deposit Chosen Charity (appears on gift tag) Cancer Association of South Africa Chevra Kadisha Nelson Mandela Children's Fund Nkosi's Haven