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STAFF ONLY Staff Member: __________ Date processed: _________ Voucher No: __________ |
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Zafferano Restaurant |
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Voucher Payment Form TO:
Mail to ¨ Name: __________________________________________________ Telephone: Daytime No ____________Mobile:__________________ Fax: ________________ Email:_______________________________ Postal Address:____________________________________________ MESSAGE: “Happy Birthday” ¨ “Congratulations” ¨ “Thank you” ¨ “Happy Anniversary” ¨ Other: ___________________________________________ FROM:
Mail to ¨ Name: _________________________________________________ Telephone: Daytime No: (__)____________Mobile:______________ Fax: (__)_____________ Email:_______________________________ Postal Address:____________________________________________
PAYMENT DETAILS Date:______________ CASH ¨ EFTPOS ¨
MASTERCARD ¨ VISA ¨ AMEX ¨ BANKCARD ¨ DINERS ¨ OTHER ¨ CARD HOLDERS NAME: _________________________________ CARD NUMBER: _________________________________ EXPIRY DATE: __________ CARD HOLDERS SIGNATURE: _________________________________ Value in numbers : $_________ Value in letters: ______________________________________ |
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