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Gift Purchaser Information:

Name:
Street Address:
Apt./Suite:
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Gift Receiver Information:

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Gift Specifics:

Today's Date: -- mm/dd/yy
Date to be Mailed: -- mm/dd/yy
Mail to: Gift Purchaser Gift Receiver ($2.00 Shipping Charge)

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Choose Gift Package to be Sent:

The City Escape ($332.00)
The Body Retreat ($221.00)
The Spa Journey ($272.00)
The Afternoon Getaway ($145.00)
The Men's Escape ($185.00)
Non-Specific (specify dollar amount below)

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