Pat Garrett Amphitheater Certificate Printable Order Form

Pat Garrett Amphitheater Certificate Order Form

Print Order Form - Fill Out
Mail payment with a stamped, self-addressed #10 (business size) envelope to:
Pat Garrett Amphitheater Ticket Sales
P.O. Box 84, Strausstown, PA 19559 USA
or FAX 610-488-1576 (Credit Card Payment Only)

Shipped to:
Name on Card:___________________________________
Address:___________________________________
City:___________________________________
State/Providence:______________________Zip:_____________
Country:___________________________________
Date of Order ____/____/____

$25.00 Gift Certificate	Qty.	Subtotal
$50.00 Gift Certificate	Qty.	Subtotal
$75.00 Gift Certificate	Qty.	Subtotal
$100.00 Gift Certificate	Qty.	Subtotal
Add $2.00 Non Refundable* Credit Card Handling Charge For Each Certificate
		Order Total

No refunds or exchanges for any reason. Purchase of certificates implies acceptance of this policy.

Method of Payment
____Personal Check (2 weeks to clear) or Money Order enclosed (Payable to Pat Garrett)
____Credit Card*
(Select One) ____VISA ____ MC ____Disc
Card Number___________________________________
CID Number ________ (Located on the back of your card after the creditcard number)
Expiration Date ____/____/___
Signature (Required for Credit Card Orders)________________________________

Thanks for your order, Pat

Official Use Only
Date Received	___/___/___
Date Shipped	___/___/___