Zinc Restaurant Port Douglas
Restaurant, bar, cafe

Zinc Gift Voucher Order Form

Ensure that you complete all relevant fields.  Once complete, print this page, sign where indicated and fax it to the restaurant.

Select a value: (Australian Dollars)
Recipient's name:
Message to appear on voucher (optional):
Delivery method: Fax to -
...or...
Email to -
...or...
Mail to the following Australian address 

Your name:
Your email address:
Your phone number:
Payment method: Visa / Mastercard / Amex
Card number:
Expiry date:
Comments:

Please print this page, sign below and fax to 61 7 4099 5926

Signed:

______________________________

By signing this form, you agree to have the above amount charged to your card.