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GIFT CERTIFICATE . . . If you are interested in obtaining a gift certificate to give a couple to attend a Marriage Encounter weekend, please fill in this request form and contact Madison Marriage Encounter (information below) to complete the gift certificate request.  Thank you!

MADISON MARRIAGE ENCOUNTER

GIFT CERTIFICATE REQUEST

A request for a Gift Certificate in the amount of

$_____ (enclosed) is being made for the following couple.

Name: _________________________________

Address: _______________________________

City/State/Zip: ___________________________

Phone: (______)__________________________

The request is being made by:

Purchaser(s):

Address: ________________________________

City/State/Zip: ___________________________

Phone: (______)__________________________

Handling of the certificate(s) - Please check one:

____Send certificate to couple receiving the gift certificate.

___ Send certificate to purchaser(s).

Madison National Marriage Encounter

Please contact Lisa & Mike Friar to obtain details on gift certificate purchases

(608-436-8526)

Email Madison Marriage Encounter