Download the PDF Form

Or Create your own form to fax in with the following on it:

Name of Cardholder
Billing address for the card
Credit Card Number
Receipt Requested Y or N
3 or 4 Digit security code
Contact Phone number
Cardholder Address
Signature of Cardholder

Amount of Gift Certificate
(added $1 for postage)

Name of Recipient
"From" name on Gift Certificate
Message on Gift Certificate
Choice of Restaurant (may be redeemed at either restaurant) FH or ENC

If no access to fax machine, call 305-451-4665.