Concierge Order Form
Please use the following form to place each individual gift order. Be sure to view our Gift Basket Portfolio, to check your information, before submitting your order. VIP Gifts and Baskets cannot be held responsible for mistakes in the information provided.
Order Date: Ordered By: Hotel:
Contact Email: Contact Tel:
Item: Quantity: Price:
Guest Name: Tower: Room:
Requested Delivery Date: Requested Delivery Time:
Gift Card Message:
Credit Card: Card #: Exp. Date: CVC:
Full Name Associated with Card:
Address Associated with Card:
City: State: Zip:
Buyer's Tel: Buyer's Email: