Online Sales

THE GALLERY KINSALE - GIFT VOUCHER PAYMENT

* Denotes required field
CARDHOLDER NAME *

CARDHOLDER ADDRESS *

EMAIL *

PHONE

CARD TYPE

CARD NUMBER *

EXPIRY DATE * CSC CODE * ?

COLLECT VOUCHER or POST
(please select option) CollectPost
POSTAL ADDRESS
(if different from cardholder address)

ANY OTHER INFORMATION

GIFT VOUCHER AMOUNT
Minimum €50

Pressing the submit button means that I fully understand that the information contained in this form is treated in the
strictest confidence by The Gallery Kinsale and that my card details will be deleted when the transaction is completed.

Leave this empty:

CARDHOLDER NAME *
CARDHOLDER ADDRESS *
EMAIL *
PHONE
CARD TYPE
CARD NUMBER *
EXPIRY DATE *	CSC CODE * ?
COLLECT VOUCHER or POST (please select option)	CollectPost
POSTAL ADDRESS (if different from cardholder address)
ANY OTHER INFORMATION
GIFT VOUCHER AMOUNT Minimum €50