Pluckemin Inn Gift Card Order Form

Gift Certificate
Order Form

About the Gift

• This Gift Certificate is FOR:

• In the AMOUNT of:
• And it is FROM:

Special NOTE or Message:

Payment Information

• Credit card type:	VISA MasterCard American Express Discover
• Credit card number:
• Expiration date:
• Security code:	What is this?

Send Gift Certificate To

• First Name
• Last Name
Company
• Address
Address
• City
• State
• Zip Code

Billing Address

• First Name
• Last Name
Company
• Address
Address
• City
• State
• Zip Code
• Phone
• Email

You will receive notification of this form being received by the Staff, and when the Gift Certificate is mailed out. Pluckemin Inn will send all Gift Certificates in a specially-made folded card, which holds the Gift Certificate, and it will mail in a Pluckemin Inn custom envelope to the address specfied above. Any further questions, please contact Amichay Miller at (908) 658-9292.