Gift Certificate Order Form

Gift Certificate Order Form

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Altnaveigh Gift Certificate Order Form: (*=required)
*Today's Date:
*Your Name:
*Address:
*City, State, Zip:
*Phone:	(Specify day or evening)
*Gift Amount:	PLUS: Please include $2.00 shipping & handling charge in your final payment for all gift certificate orders.

*Make Certificate Out To:
*Certificate Signed From:
Occasion (if any):

Payment Type:Check or Money Order Enclosed Credit Card

Your Credit Card Information:
*Credit Card Type:
*Card Number:
*Exp. Date:
*Cardholder Name:
*Signature:

Mail Certificate To Information:
*Name:
*Address:
*City, State, Zip:

Thank you for your order!

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The Altnaveigh Inn & Restaurant
957 Storrs Road (Route 195)
Storrs, CT 06268
Telephone: (860) 429-4490