Gift Certificate Order Form

Thank you for your interest in Alchemy Wellness. Please begin by completing our online order form and credit card authorization.  You will then be directed to Pay Pal to complete your transaction.

Recipient First Name *

Recipient Last Lame  *

Address1

Address2

City

State or Province

Zip or Postal Code

Country

Phone *

Email  *

Purchased By *



CREDIT CARD AUTHORIZATION AGREEMENT:

I hereby authorize  Alchemy Wellness to charge my Credit Card, E-Check or Bank Debit Card for Gift Certificate purchases which will be completed though Pay Pal.  I understand that all online purchases for Gift Certificates with Alchemy Wellness are final and must be used within nine months from the date of purchase.  I understand that Gift Certificates are non-transferable and must be used by the Recipient designated in the above order form, and that an Electronic Gift Certificate will be issued upon completion of purchase.

* Required Fields


I have read the Alchemy Wellness Credit Card Authorization Agreement above, understand, and agree to these terms.