Two-Year Referral Package Order Form

If you are new to White Glove Client Services, please read the informative About Referral Packages.

Please click here for our One-Year Referral Package.

Approval Status:
Account Number:
Payment Options:
Start Date/First Delivery:
Package Options:
Additional Package Options:
Gift Options:
Starting Event Gift & Card (approximate value $35):
Holiday Gift & Card (approximate value $35):
Event Gift & Card (approximate value $25):
Anniversary Card (approximate value $5):

Recipient Delivery Data:

Recipient Delivery Data is used solely to facilitate gift selection and delivery. This data will not be used for any other purpose, nor will it be shared with any other parties, except as required by court order.

All Recipient Delivery Data, except the address, will be redacted on archived files.

Cost (plus H.S.T.):  $200

Thank you. We will review your order as soon as possible.