Premier Gift Certificates

Order Form

 

What type of gift certificate would you like to purchase? (Choose 1 or more services for a SINGLE gift certificate)
	Personal Training Please select BodyAge Assessment | $85 Call studio for PT gift cert options Boxing Fitness Please select Boxing 5-Week Class | $125 Unspecified--Choose $ Amount Please select $25 $50 $100 $150 $200	Massage Therapy  Please select Maintenance Program (6 mo.) | 6 x $69+tax Maintenance Program (12 mo.) | 12 x $59+tax 30-Minute (single) | $45+tax 30-Minute (3 pack) | $126+tax 30-Minute (6 pack) | $240+tax 60-Minute (single) | $75+tax 60-Minute (3 pack) | $210+tax 60-Minute (6 pack) | $396+tax 90-Minute (single) | $100+tax 90-Minute (3 pack) | $279+tax 90-Minute (6 pack) | $534+tax Tanning  Please select 1-Month Unlimited Tanning | $49+tax 3-Month Unlimited Tanning | $39/mo.+tax 6-Month Unlimited Tanning | $35/mo.+tax Med-Pressure Tanning | $12+tax Med-Pressure Tanning (3 pack) | $29+tax
	Who would you like the gift certificate to be "from"?
	Who will be the recipient of the gift certificate?
	Please provide us with your credit card information.
Type	Please select Visa MasterCard Discover AMEX
CC Number
Exp.	Month Select 01 - Jan 02 - Feb 03 - Mar 04 - Apr 05 - May 06 - Jun 07 - Jul 08 - Aug 09 - Sep 10 - Oct 11 - Nov 12 - Dec / Year Select 2008 2009 2010 2011 2012 2013 2014
Name
Address
City
State				Zip
Phone
Email
	How would you like us to handle your gift certificate?
	Mail to the address above  Hold at the studio for pickup Mail to a different address  (indicate below) Mail-to address, if different than above
Name
Address
City
State				Zip
Special Handling Instructions
	Are you a current client of Premier Fitness Studio?  Yes  No      If "no", how did you hear about Premier Fitness Studio?      Please select Another Client Building Sign (drive by) Dex Online Internet Search Engine Phone Book Postcard Mailing Posted Flyer Staff Member Wedgewood Chiropractic Woodbury Bulletin Woodbury Magazine Other