| DIVINE REDEEMER | |||
| GIFT CARD PURCHASE | |||
| Name | Date | ||
| Address | Telephone | ||
| City | State | Zip | |
| Email Address | |||
| 25% of the discount please apply to: | |||
| Store Name | Value | Qty | Total |
| Total | |||
| Payment Method ( ) Check ( ) Cash | |||
| Mail to: | |||
|
Divine Redeemer Scrip Coordinator: Tammy Gable 1104 Fort Drive Hanahan, SC 29410 |
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| Make check payable to Divine Redeemer | |||