Secure Reservation Request
Laurelville
614-499-8205
Secure Reservation Request
Gift Certificate Ordering Information
If you prefer to not order online or would like to pay by check or money order, you can print this form and mail it to us. Please complete all required fields. Please note that although credit card info is requested, we will not charge your card directly but will send you a PayPal invoice for charges. Once you have paid the invoice, we will send the gift certificate either by U.S. Mail or email depending on your timing needs.

The Order Form: (*=required)

*Your First Name

*Your Last Name

*Address

*City

*State/Province

*Zip Code

*Country

*Email

*Confirm Email Address

*Day Phone

Evening Phone

*Gift Amount


Gift Information

*Certificate Made Out To

*Make Signed From

Occasion (if any)

Mail to Name

Address

City

State/Province

Zip Code


Credit Card Information

Type of Credit Card Visa, MasterCard, Discover

Credit Card Number

Expiration Date  

Please enter the following information as it appears on your credit card's billing address. Please fill in ALL of the following, as they are required to secure your order

copy my information

Name on Card

Address

City

State/Province/Territory

Zip/Postal Code

Country



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Marsh Hollow • PO Box 460 • Laurelville  • 614-499-8205