Gift Certificate Form printable pdf download

Gift Certificate Form

PROSPECT RESTAURANT

GIFT CERTIFICATE FORM

NAME:_____________________DATE:________________________

PHONE #:_________________FAX/EMAIL:____________________

Please complete the following information and send or fax to:

Prospect Restaurant, 300 Spear Street, San Francisco, CA. 94105

Fax (415) 247-7760

I, ______________________ authorize Prospect Restaurant to charge my

credit card account for a Gift Certificate in the amount of $_______

Recipient Name and Address:

Send Receipt to:

__________________________

___________________________

__________________________

___________________________

__________________________

___________________________

Name on Card:________________________________________

Signature by cardholder:_________________________________

Card Type: Amex___ MC___ Visa ___ Diners___ Discover___

Card Number :________________________________________

Exp. Date:___________________________________________

Message:______________________________________________

Prospect Restaurant, 300 Spear Street, San Francisco, CA. 94105

Ph. (415) 247-7770, Website:

Private Dining Room

Gift Certificate Form