R E S T A U R A N T

Gift Certificate Order Form

To order today simply print this page, complete this form and either fax it to (202) 393-4744,
mail Gift Certificate Order Form to:
TenPenh, 1001 Pennsylvania Ave., N.W., Washington, DC 20004 (no cash, please.)

Please use one form per certificate.

Who is purchasing the certificate? ____________________________
Credit card number ____________________________ Exp. _______________
  Please provide copy of front and back of card with order; TenPenh will be unable to process order without copy.    
Full name as it appears on card ____________________________
Address ____________________________
____________________________
Phone Number ____________________________

Purchaser's signature
____________________________

Denomination of certificate:
$ ____________(minimum $25)
  Subtotal $ ________
Overnight service fee? $      25.00
TOTAL CHARGED TO CARD $ ________
   
       
Should TenPenh mail the certificate to the purchaser? Yes _________No___________    
Where should TenPenh mail the certificate? Name_____________________    
  Address___________________    
_________________________
Thank you for your order, please allow one week for standard mail delivery.