RHZ Gift Certificate Order Form

RHZ Gift Certificate Order Form
The Gift Certificate(s) receipt will go to the "Purchaser" email address.

The Gift Certificate(s) will be mailed to the Purchaser's address unless otherwise specified.

If you are wanting to purchase a gift certificate(s) for multiple recipients, please feel free to contact our Gift Shop at (785) 827-9488.
Purchaser Information
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gift Certificate Recipient Information
Will you want the Gift Certificate(s) mailed to the Gift Certificate Recipient?*

No, mail it to me.Yes, please mail it to the recipient instead of me.
Gift Certificate Recipient's Name*
e.g. John Smith or The Smith Family
Recipient's Phone Number*
Recipient's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please verify that you are human*
Order Details
Gift Certificate Purchase:*
prevnext( X )
$25 Gift Certificate
$25.00 Quantity



$50 Gift Certificate
$50.00 Quantity



$75 Gift Certificate
$75.00 Quantity



$100 Gift Certificate
$100.00 Quantity



Total

$0.00

Pay with Credit Card

Purchaser Information