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Blue Ox Steakhouse
> Blue Ox Private Parties
Gift Cards
Billing Information
Name*
Address*
City*, State*, Zip*
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Email*
Daytime Phone*
Payment Information
Credit Card Type*
--Select--
Visa
MasterCard
American Express
Card Number*
Card ID#*
Expiration Date*
--Month--
1
2
3
4
5
6
7
8
9
10
11
12
--Year--
2012
2013
2014
2015
2016
2017
2018
Name on Card*
Recipient / Shipping Information
Name
Address
City, State, Zip
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Order Information
Gift Amount*
$
PLEASE ONLY ENTER NUMBERS
Quantity*
Thank You.
Total
Need Card By:
--Month--
January
February
March
April
May
June
July
August
September
October
November
December
--Day--
1
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Comments/Gift Message
I Authorize Blue Ox to Charge my Credit Card the Above Amount*