100'   Party Boat                   MAILING ADDRESS:  11 Downing Dr, E. Brunswick, NJ  08816

       GOLDEN       VESSEL LOCATION:  Belmar Marina, Commercial Slip #2, Belmar, NJ

               EAGLE       Office Phone 732/681-6144   Fax 732/613-2756

 

                                              GIFT CERTIFICATE ORDER FORM

 

        PLEASE FILL IN ALL THE SPACES & MAIL TO THE ABOVE ADDRESS WITH YOUR MONEY ORDER OR PERSONAL CHECK PAYABLE TO GOLDEN EAGLE.  YOU MAY CHARGE TO MASTER CARD OR VISA BY COMPLETING THE APPROPRIATE SECTIONS BELOW & MAIL OR FAX.  A CHARGE OR MONEY ORDER IS PROCESSED UPON RECEIPT.  IF YOU USE A PERSONAL CHECK THERE WILL BE A DELAY IN PROCESSING UNTIL YOUR CHECK CLEARS.   PLEASE PRINT LEGIBLY.

 

 TODAY'S DATE:                                    

 

NAME OF GIFT RECIPIENT:                                                                                                  

 

DOLLAR VALUE OF EACH CERTIFICATE (Circle or fill in your own).  T-shirts and hats available on board.

 

                    $25   $30   $35   $40    $45    $50   $100   $200     OTHER $             

 

NUMBER OF CERTIFICATES TO BE ISSUED:                      

 

HANDLING (Circle One)  Regular Mail - No charge     Overnight - $19.75     2 Day Priority - $5.00

 

TOTAL DUE:     $                                 Paid By     CHECK ENCL             or         CHARGE         (Circle One)

 

GIFT FROM:                                                                                                                                                     

                            (name of the person(s) who gift is from - Mom/Dad, kids names, Grandparents, etc. whatever you want)

 

OCCASION:                                                                                                                                                         

(ANNIVERSARY, BIRTHDAY, RETIREMENT, VALENTINE, MOTHER'S/FATHER'S DAY, CHRISTMAS, HANUKKAH or make up your own)

 

NAME, ADDRESS & PHONE # OF WHERE YOU WISH CERTIFICATE SENT:

                                                                                                            Name

 

                                                                                                            Street

 

                                                                                                            City, State, Zip

 

                                                                                                            Phone w/ area code

 

CHARGE TO MY    VISA    OR    MASTER CARD   (circle one)

 

Card #                                                                                          Exp. Date                

 

VCODE                     (3 digit code on back of card) 

 

SIGNATURE AUTHORIZATION  X                                                                                      

Card holder Information:

                                                                                                                                    Name on card

 

                                                                                                                                    Street

 

                                                                                                                                    City, State, Zip

 

                                                                                                                                    Phone w/ area code