Cafe Juanita
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Gift Certificates

Welcome to the Cafe Juanita Gift Certificate Ordering Site. Your credit card will not be processed when you select the Submit button below. Instead, it will be manually processed at the restaurant by Cafe Juanita. If you realize you made an error after selecting the Submit button, please contact us at 425.823.1505 or by email and we will make any changes you require.

Please fill out all of the information requested on this form. Incomplete submissions will prevent us from being able to issue your Gift Certificate. When you have filled out all of the information you will be automatically returned to the Cafe Juanita Website. You will leave the secure website when you return to the main page.

Please allow up to 48 hours for processing and mailing of our beautiful handwritten gift certificates. 

(* indicates a required field)

Billing Information
First Name *:
Last Name *:
Phone *:
Email *:
Address 1 *:
Address 2:
City *:
State *:
Zip Code *:
Country *:


Gift Certificate Information
Gift Certificate Amount: *
Are we mailing the certificate to you? *   Yes   No
If "no", please provide the following information:
Recipient First Name:
Recipient Last Name:
Recipient Address 1:
Recipient Address 2:
Recipient City:
Recipient State:
Recipient Zip Code:
Recipient Country:


Credit Card Information
Payment Type: *  Visa   MasterCard   American Express   JCB
Credit Card Number: *
Expiration Date: *
Name on Card: *
Would you like a copy of the receipt? *   Yes   No


Additional Instructions
Please use the space below to provide any special instructions, including such things as special salutations, a target mailing date, or any other comments or questions.
 
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