Gift Card Order Form

If you would like to order a Gift card, please fill in the form below and make payment to:

MILAAN HOLDING LIMITED
BNZ Bank Account:
02-0496-0151629-000

Payment Reference:
GiftCard and Your Name

Once payment is confirmed, an eGift card will be sent to the recipient email address given below.

Gift Card Amount

Name

First

Last

Phone

Address (optional)

Address Line 1

City

State / Province / Region

Country

Recipient Name

First

Last

Recipient Email

Date Payment Made

GiftCard and Your Name