Don't know what to give?

KIein's Floral and Greenhouses gift certificate is the perfect gift!

Please PRINT this page on your computer, fill it out,
then FAX it to us at 608 244-2649
Or, call us during business hours at 608 244-5661 with the same information.

Please DO NOT EMAIL us with your credit card information, as this is not secure.

YOUR NAME as printed on your credit card.
(We accept Mastercard, Visa, American Express or Discover)

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YOUR PHONE NUMBER with area code (            ) _________ - ___________

YOUR BILLING ADDRESS for your credit card.

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(We will send your credit card receipt to this address)

NAME AND ADDRESS TO SEND THE GIFT CERTIFICATE
We can send the gift certificate to you, or directly to the recipient. Write "SAME" if you want it sent to you at the above address.

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CREDIT CARD NUMBER
(We accept Mastercard, Visa, American Express or Discover)

__________-__________-__________-__________

EXPIRATION DATE month ______ year______

VERIFICATION CODE _________
(turn your card over, and give us the last 3 digits of the number directly above the signature line)

DESIRED AMOUNT for the gift certificate. $___________
Note: lost or stolen gift certificate will not be replaced.

RECIPIENT'S NAME (TO) written on gift certificate ______________________________________

SENDER'S NAME (FROM) written on gift certificate ______________________________________

MESSAGE TO WRITE ON ENCLOSURE CARD (optional)

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