• Please fill in the information below. Your order is on a secure server.
• You will receive an email confirming your order.
• Your gift certificate can be either emailed or mailed to you or the recipient.

PURCHASED BY:

First Name Last Name

Street Address City

State Zip

Email Address (*Required Field- Need so I can send confirmation)

PAYMENT METHOD:

American Express Visa Mastercard Discover

Credit Card Number Expiration (example- 07/02)

TYPE OF GIFT CERTIFICATE:

Christmas Certificate Regular Certificate

Gift Certificate Amount: One Hour Lesson- $140.00 One Hour (2 people) Semi Private Lesson- $150.00 Eight - 1 Hour Lessons Series- $840.00 Four - 1 Hour Lessons Series- $460.00 Junior(Age 8-17)- One Hour- $125.00 Junior(Age 8-17) 8 - One Hour Series- $720.00 Junior(Age 8-17) 4 - One Hour Series- $400.00 Four - 1 Hour Semi Private Lessons(2 people)- $500.00 2.5 Hour Power Session- $295.00

GIFT CERTIFICATE PURCHASED FOR:

Recipient name on certificate:

MAIL CERTIFICATE TO:

Email (will print in color if using a color printer)

Purchaser-address above

Address Below

First Name Last Name

Street Address: City

State Zip

HOW DID YOU HEAR ABOUT MICHELLE DUBE?:

Southland Golf Magazine Website California Golf Magazine Friend Brochure

Tijeras Creek Driving Range Other