Gift Certificate Order Form

Print this form, fill out the requested information and fax it to: 262-375-0387 or mail with check to:

Carter's Salon, 1350 14th Ave, Suite 307, Grafton, WI 53024
Sender Information: (please print clearly)

Name:                                                                                                                                    

Address:                                                                                                                                

City, State, Zip:                                                                                                                    

Phone:                                                               

Dollar Amount:  (circle one or specify an amount)   $25   $50   $75   $100   Other:       

Recipient Information: (please print clearly)

Name:                                                                                                                                    

Address:                                                                                                                                

City, State, Zip:                                                                                                                    

Phone:                                                               

Credit Card Information:

Type of card: (please circle one)   Visa   Master Card  

Name on Credit Card:                                                                                                       

Card Number:                                                              Expiration Date:                           

Cardholder's Signature:                                                                                                   

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