Gift certificate order form

1
What is your name?* This field is required.
First Name
Last Name
2
Phone number* This field is required.This will be used to reach you in case you can't be reached by email.
3
E-mail* This field is required.This will be used for invoicing, and to arrange delivery of the gift certificate.
4
Who is the super lucky person are you buying the gift certificate for?* This field is required.If buying for more than one person complete details for the first person here. You will be given the option of adding certificates for more than one person below.
5
How would you like their name and your name to appear on the gift certificate?* This field is required.
6
What type of gift certificate would you like?Select as many sessions as you would like to make a combo pack
Foot $75
Hand $75
Face $75
Some extra love $95
Headache and sinus relief $80
Hot stone reflexology $80
Ultimate renewal $120
Reflexology Lymphatic drainage $75
Reiki $80
R&R $105
Indian head massage $90
Recovery bliss $95
7
I'm not sureNot sure what session they would like, that's okay, you choose the amount, and they decide how to spend it. Please type the dollar amount you would like to purchase?
8
How would you like the gift certificate?* This field is required.
In print
Electronic
9
If you would like the gift certificate emailed directly to the recipient add their email address here.
example@example.com
10
Buying for more than one person?* This field is required.
Yes
No
11
Who is the super lucky person are you buying the gift certificate for?* This field is required.
12
How would you like their name and your name to appear on the gift certificate?* This field is required.
13
What type of gift certificate would you like?Select as many sessions as you would like to make a combo pack
Foot $75
Hand $75
Face $75
Headache and sinus relief $90
Hot stone reflexology $90
Ultimate renewal $120
Recovery bliss $95
Reiki $80
R&R $105
Indian head massage $90
14
I'm not sureNot sure what session they would like, that's okay, you choose the amount, and they decide how to spend it. Please type the dollar amount you would like to purchase?
15
How would you like the gift certificate?* This field is required.
In print
Electronic
16
If you would like the gift certificate emailed directly to the recipient add their email address here.
example@example.com
17
Special Delivery InstructionsIf you need to add more detail or are purchasing for more than two people please give details here.
18
You will receive an invoice within 1-2 business days, along with details on the gift certificate delivery. Thank you for being an awesome gift giver.

905-464-8076
4187 Sutherland Cres
Burlington, ON L7L 5G3
michelle@handstoheel.com
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