*** Frederick's Day Spa Salon***
Gift Card Order Form
Date:			Please print clearly
Name:
Address:
City:
State:		Zip:			Phone:
Method of Payment: (Check ___) (Credit Card ___)
Credit Card:   Visa ___  Mastercard ___  Discover Card ___
Credit Card Account Number:
Expiration Date: Month_____ Year_____
Gift Certificate Amount: $ OR Salon Package:
Mail to recipient? Yes___ No___
Recipient's Name:
Recipient's Address:
City:
State:	Zip:			Phone:
Comments:
Print out, complete form and fax to us at 304-242-1569 If paying by check, send payment with form to 109 Edgington Lane, Wheeling WV 26003. Thank you for choosing Frederick's Day Spa Salon!

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