NAIL & MASSAGE SPA • 677 Queensway, Etobicoke, Toronto, Ontario, Canada • Phone: 416-253-6113 • e-mail 中文  
 
       
     
   

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Please Delivery This Fax To: ____________________________

Fax Number: _________________________________________
Upon completion of this form please fax to 416-253-6113
Date ___________________________________
Telephone Number ___________________________________
Cardholder's Name ___________________________________
  VISA MasterCard
Credit Card # ___________________________________
Expiration Date _________/_________
Amount $__________________
Delivery Charge $ 2.00 by Canada Post
Total $__________________
Signature ___________________________________
Gift Service/ Day Spa ___________________________________
______________________ ___________________________________
______________________ ___________________________________
To ___________________________________
From ___________________________________
Message ___________________________________
Address to be sent ___________________________________
  ___________________________________
  ___________________________________

For office use only:

Date _______________ Trans ______________

Cert _____________________________ Initials ________________

 

 
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