Gift Certificate Order Form

ITEM	QUANTITY	FEE	TOTAL
1 Hour Massage
½ Hour Massage
Fitness Assessment & Personal Training Program Design
Personal Training
Theater tickets
Concert tickets
Membership
Other

Date: ________________________

Payment Method: o Cash o Check o Master Card o Visa

Recipient: ___________________________________________________________________

From: ____________________________________________________________________

Gift Certificate given at the time of purchase? oYes o No

Gift Certificate made by (employee’s name): ____________________________________

If not, o mail gift certificate (Address: ____________________________________________)

OR

o gift certificate to be picked up by customer (Phone # ____________________)