Rice Lake Chamber Bucks Order Form

"*" indicates required fields

Name

First Last

Business Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

I will pick the Chamber Bucks up at your office

I would like the Chamber Bucks mailed to me

Please state exactly who the Gift Certicate should say it is from.

$5 Chamber Bucks

Price: $5.00

$10 Chamber Bucks

Price: $10.00

$20 Chamber Bucks

Price: $20.00

$25 Chamber Bucks

Price: $25.00

Total

Paying

Credit Card

Invoice

Cash/Check When Picked Up

Other

Credit Card Payment Transaction Fees

Price: $0.00

Subtotal

$0.00

Credit Card

Card Details

Cardholder Name

CAPTCHA

Support your Local Chamber Member Business! Order Rice Lake Chamber Bucks. Accepted by Chamber Members.

Fill in the information for your Chamber Bucks purchase and stop and pick them up at the Chamber office or let us know if you would like them mailed to you.