THE ELMS INN
500 Main Street Ridgefield, CT 06877
E-MAIL ORDER GIFT CERTIFICATES (The Restaurant Only)

NOTE: We can not guarantee delivery of orders placed after the 19th of December to arrive by mail before Christmas.
 
TO WHOM:
    First Name:
    Last Name:
    Address:
    City:
    State:
    Zip:
    Phone:
 
FOR WHOM:
    First Name:
    Last Name:
    Address:
    City:
    State:
    Zip:
    Email:
    Phone:
 
PAYMENT INFORMATION:
    Amount($):
    Credit Card:
    Card Number:
    (no dashes or spaces)
    Expiration:
    Full Name on Card:
 
MESSAGE:
 
FOR OFFICIAL USE:
    GC Number:
    Date Mailed:
  











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