Birthday Keepsakes Gift Certificate Order Form
Please complete this form and then fax or mail it to us.
FAX (970) 669-5052 (credit card orders only) Please allow 2 - 3 weeks for delivery.		Birthday Keepsakes LLC P.O. Box 7679 Loveland, CO 80537-0679 Please allow 4 - 5 weeks for delivery. Please include check, money order or credit card information with order form.

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Gift Note Information
From
To
Message
If you would like the Gift Certificate sent by email, please enter an email address below. Make sure you also include a Ship To address just in case we have a problem with the email address.
Email Address

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Ship To			Bill To
Name			Name
Address			Address
City			City
State			State
Zip			Zip
Country			Country

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Order Details
Gift Certificate Amount	$_____________
Sales Tax   CO residents add 3.7% sales tax   (0.037 x Subtotal)	$_____________
Shipping	$_________0.00
Total	$_____________

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Payment Information
I am paying by Check    Money Order    Credit Card
Credit Card Type	Visa    MasterCard
Credit Card Number
Name on Card
Expiration Date	/
Signature	________________________________________