Please print this page and fill out the following information to purchase a gift certificate: Your Name: _______________________________________________ Your Address: _________________________________________________________ City:______________________________State_______________ Zip: _____________________ Your Phone Number (work): (_____)______-_______ (home): (_____) _____-______ Gift Certificate TO: ___________________________________________ Amount on Gift Certificate: $____________________________ Gift Certificate FROM: ________________________________________ Certificate will be mailed to: Name: _________________________________________________ Address: ________________________________________________ City:___________________________State: _____________ Zip: ______________________ Credit Card information (circle one): MasterCard / Visa / AmEx #__________________________________________________ exp ___/___ Please mail or fax this sheet to Cinnabar Hills Golf Club, 23600 McKean Rd, San Jose, CA 95141, fax #: (408) 323-9512 Please no cash or checks

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