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Gift Card One: |
| Gift Card Amount: | $ |
| Gift Card Design: | |
| If you would like this gift card sent directly to the recipient, please fill out the following information: |
| Name | |
| Address | |
| City | |
| State | |
| Zipcode | |
| To: | |
("Mom", "Dad", nicknames, first names, etc. are acceptable) |
| From: | |
("Mom", "Dad", nicknames, first names, etc. are acceptable) |
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| Send gift card via: |
| U.S. Postal Service, First Class Mail (free of charge) |
| FedEx ($11.00 shipping charge for standard overnite delivery, post office box address not acceptable, may not be available for delivery in all areas. $13.00 for Alaska or Hawaii.) |
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Gift Card Two: |
| Gift Card Amount: | $ |
| Gift Card Design: | |
| If you would like this gift card sent directly to the recipient, please fill out the following information: |
| Name | |
| Address | |
| City | |
| State | |
| Zipcode | |
| To: | |
("Mom", "Dad", nicknames, first names, etc. are acceptable) |
| From: | |
("Mom", "Dad", nicknames, first names, etc. are acceptable) |
| |
| Send gift card via: |
| U.S. Postal Service, First Class Mail (free of charge) |
| FedEx ($11.00 shipping charge for standard overnite delivery, post office box address not acceptable, may not be available for delivery in all areas.$13.00 for Alaska or Hawaii.) |
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Customer Information: |
| Please note that this address must match the billing address of the credit card used. We reserve the right to verify any order by phone before processing. |
| First Name* | |
| Last Name* | |
| Company Name | |
| Address* | |
| City* | |
| State* | |
| Zip Code* | |
| Daytime Telephone* | Format: xxx-xxx-xxxx |
| Evening Telephone* | Format: xxx-xxx-xxxx |
| Email Address* | |
| Send via: |
| U.S. Postal Service, First Class Mail (free of charge) |
| FedEx ($11.00 shipping charge for standard overnite delivery, post office box address not acceptable, may not be available for delivery in all areas. $13.00 for Alaska or Hawaii.) |
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| Unless you have instructed us to mail a gift card directly to a recipient, your gift card(s) and confirmation of your credit card payment will be mailed to the address completed in the customer information section above. (Please complete the information requested below ONLY if you wish us to mail your credit card receipt and gift card(s) to a different address.) |
| First Name | |
| Last Name | |
| c/o | |
| Address | |
| City | |
| State | |
| Zip Code | |
| Send via: |
| U.S. Postal Service, First Class Mail (free of charge) |
| FedEx ($11.00 shipping charge for standard overnite delivery, post office box address not acceptable, may not be available for delivery in all areas. $13.00 for Alaska or Hawaii.) |
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Credit Card Information: |
| Name as it appears on card* | |
| Type of card* | |
| Credit Card Number* | |
| Expiration* | |
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| If there is a question regarding my order, please contact me through any of the following: |
EMail Daytime Telephone Evening Telephone
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| Please verify carefully all the information you have entered above before submitting your order. |
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