Gift Certificate Request Form

Name

Address

City State ZIP

Your e-mail address

Make certificate in the name of

Make certificate in the amount of

We can mail this certificate to the recipient with your comments if you provide the following. Otherwise, we will mail it to you or send you a printable JPEG file .

Recipient's address  

Your comments

Please remit your certificate payment to Mello Pottery, 3129 Baker Road, Springfield, OH 45504 within 5 business days. We accept personal check or money order.

All excess certificate value will be applied toward future purchases. All applicable taxes apply to all purchases.