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GIFT CERTIFICATES

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Today's Date: _____/_____/_____
Type of Credit Card:
___________________________________________
Card Member's Name:
___________________________________________

Phone #: (________) ________-___________

Credit Card #:
___________________________________________
Expiration Date: _____/_____

Gift Certificate to read as follows:
To:
___________________________________________
From:
___________________________________________
Message:
___________________________________________
___________________________________________
___________________________________________

Amount: $_______

(**We recommend the following guideline for two persons including tax & tip: $50 for Lunch/Brunch & $100 for Dinner.  Certificates must be used for the entire amount; no cash or credit will be issued.)

Mail Certificate To:
___________________________________________
___________________________________________
___________________________________________
Mail Date: _____/_____/_____
Fed Ex Option:    YES    NO    
(additional fee applies)

** You MUST include a photo-copy of the front and back of your credit card along with your signature and phone number before we can process the certificate.  Return this form completed via fax to (212) 966-6718

Card Member's Signature:
__________________________________________

Phone Number:
(________) ________-___________