Gift Certificate Purchase | Blue Ribbon Travel

Name*
Email*
Gift Certificates and Travel Vouchers are to be used toward airline tickets, tour packages or cruises. Pre-paying for the certificate is by Check or Cash, they cannot pre-pay with a Credit Card. Have you made the buyer aware of the conditions?*
- Yes
- No
Type of Certificate/Voucher*
Purchased By*

First

Last
Company Name
Phone
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Purchase For*

First

Last
Phone
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Amount of Certificate/Voucher*
Purchase Date*

MM slash DD slash YYYY
Certificate Expiration Date

MM slash DD slash YYYY
Form of Payment*
Credit Card Number
Expiration Date

i.e. 11/14
Name on Credit Card

First

Last
Amount to Charge Credit Card
Type of Credit Card
- Corporate
- Personal
Comments