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Gift
Certificate Form BUYER'S INFORMATION Name ___________________________________________ Address _________________________________________ City & State _____________________ Zip Code_________ Country __________________________________________ E-mail Address____________________________________ Day phone (____) _________________________________ Eve Phone (____)_________________________________ Would you like to be added to our mailing list? myes mno
RECIPIENT'S INFORMATION Name ___________________________________________ Address _________________________________________ City & State _______________________Country_________ Zip Code (or Postal Code) __________________________ Day phone (____) _________________________________ Eve Phone (____)_________________________________ Would you like the recipient added to our mailing list? myes mno
CERTIFICATE INFORMATION (please choose one): m dollar amount $___________ m public class (list specific class name & date) __________________________________________________ m Friday Night Dinner for ____ people ($32/person) m store merchandise ______________________________
Mail gift certificate to (please check one): m buyer m recipient m will pick up at The Natural Gourmet
What short message should we put on your gift certificate?: __________________________________________________ Who is it from? (if other than just the buyer): __________________________________________________
PAYMENT INFORMATION (please check one) mCheck mMoney Order mVisa mMC m Amex Credit Card # __________________________exp. date___________ CVV2
code (a three-digit security number located on the back of your credit
card Signature (required):______________________________________________
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