Gift Certificates

Please print the form below, fill it out, and then call Karen Gilman at 607.582.7555 before you fax the form. Dano's accepts Visa and Mastercard.

Credit Card Information:

Type of credit card (circle one) : _____Visa______Mastercard

Credit Card Number : __________________________________________________________

Expiration Date : _____________________________________________________________


Amount : $ _________________
(Recommended amounts might be $30 for lunch
and $50 for dinner)

Cardholder's Name : ___________________________________________________________


Signature : __________________________________________________________________

Telephone Number : ( _______ ) ___________________________________ ext.: ________

Gift Particulars

Certificate Date : ____________________________________________________________

To : _______________________________________________________________________

From : _____________________________________________________________________

Message : __________________________________________________________________

Mail Certificate to : __________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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