Kokomo Jr., America's Favorite TV Chimpanzee
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Kokomo Jr. Award Request - Centennial

To submit a request for a Kokomo Jr. Centennial Certificate, simply fill out the form below.  If your browser does not support this form, please email the information to sales@kokomojr-tvchimp.com.
The centenarian's name:
Date of birth:
Address to send award to:
 
Your name:
Your email address:
Your phone number:
 
   

Note: Your email and phone number will remain confidential - we do not distribute mailing lists to other companies.  We request this information so that we will be able to contact you if we have any questions when processing your request.