Gift Certificate

Gift Certificate Form Please Print

From

      Date _________________________________

      Name __________________________________
        Print name(s) the way you want it to appear on certificate.

      Address ________________________________

      City _________________________ State ______ Zip ________________

      Home Phone _______________________________

      Email ____________________________________
        (In case we need to contact you.)

      Amount of Gift Certificate $________________ (Any amount of $25 or more)

      Message on Certificate (optional) _________________________________
      (Limited to 70 charters, including spaces)

      I want to remain anonymous. ____

      Do you want us to mail the certificate to you____ or to the recipient ____?

      Recipient to receive certificate - approx. date______________________ (No guaranties!)

To

      Name __________________________________

      Address ________________________________

      City _________________________ State _____ Zip ________________

      Enclose this form, payment and send to:

Vandenberg Perennial's
W7342 Anderson Ave.
Shawano, WI 54166

THANK YOU, for your order!