GIFT CARD 
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                    Submit Parameters 
                
                       
                    I am the customer
                 
                
                       
                    I am submitting on behalf of the customer
                 
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                Processor Contact: 
                    http://paymentech.com/ 
                
            800.254.9556  | 
        
| Your Name | 
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| Customer Email (required) | 
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                 Submitter Email (required) 
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| Site Name | 
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| Country | ||
| Site Address | 
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| City | 
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| State | ||
| Zip | 
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| Merchant # | 
                
                * 12 digits | 
            
                   Gift Tested OK
                   Gift Test Failed: 
      Info Here 
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| Client # | 
                
                * 4 digits | 
            
                 
                    Processing...! 
             
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| Terminal # | 
                
                * 3 digits | 
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                 Net Connect 
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                    * User Name 
            * Password  | 
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| Notes | 
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