gift form 12-12-19

TEDDI AND ARCHELL GIFT CERTIFICATE ORDER FORM

Purchaser's Name

REQUIRED

Address

REQUIRED

Apt./Unit # (if applicable)

City, State, Zip Code

Contact Phone Number

Email

REQUIRED IN CASE WE NEED TO CONTACT YOU

Please Select an Amount

NAME AND ADDRESS MUST MATCH CREDIT CARD INFORMATION

Credit Card Number - DO NOT USE SPACES OR DASHES

REQUIRED

Expiration Month

REQUIRED

Expiration Year

REQUIRED

Enter 3 digit security code from the back or the 4 digit code on AMEX

Security Code

REQUIRED

Name To Be Put On Gift Card

REQUIRED

Message on Gift Card (optional)

Gift Card Delivery Options

I Will Pick It Up Please Mail It

REQUIRED

FILL OUT THE FOLLOWING ONLY IF THE CARD IS TO BE MAILED

Name of Mail Recipient

Street Address of Recipient

Apt./Unit # (if applicable)

City, State and Zip Code