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Ph:	(03) 9511 4954
Mob:	0418 348 308
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Thursday, 20th November 2008

Inquiries and Contact Me

Thank you for taking an interest in Civil Celebrations. Please make an inquiry by filling out the form below and I will contact you as soon as I receive it.

Fields marked with a Star are mandatory, however the more information you provide, now, the less information will need to be gathered later.

Please rest assured that your privacy is paramount.

Best wishes
Gillian Russell

Full Name:

Address:

Town/Suburb:

State:

Post Code:

Phone Number, Please Include Area Code

Phone Number:

Fax Number:

Mobile Number:

E-Mail Address:

Please tell me about the type of ceremony you would like.

Weddings		Significant Age
Renewal of Vows		Retirement
Commitment ceremonies		Funerals
New Home		Divorce/Separation
Permanent relocation		Other
Memorial services

Other, Please advise:

Who is to be involved in your ceremony and how will they assist?

Person 1:

Person 2:

Other People

Proposed ceremony date and time

Date:

Time:

Specific requirements:

Proposed venue and address

Distance from CBD (approx)

I will confirm that I have received your booking as soon as possible and that I am available. A $200.00 non refundable deposit is then to be forwarded to Gillian Russell, 212 Lum Road, Wheelers Hill 3150. Direct Debit is available and account details are available if this is preferred.