The Boulders Inn, New Preston, Connecticut

Gift Certificate Order Form Please fill out the following information, and we will promptly contact you for payment options. Thank you! *Fields preceded with are required.**
	a
Purchaser Information	First Name	*
	Last Name	*
	Address 1	*
	Address 2
	City	*
	State	*
	Zip Code	*
	Country
	Daytime Phone	*
	E-Mail	*
	Best Method of contact	*
	a
Recipient Information	First Name	*
	Last Name	*
	Address 1	*
	Address 2
	City	*
	State	*
	Zip Code	*
	Country
	a
Additional Information	Gift Certificate Amount	*
		a
	Mail Gift Certificate to:	*
		a
	Do you want the value on the Gift Certificate?	*
		a
	Do you want the TO/FROM filled in?	*
		a
	Additional Comments
	a
Submit the Form