Please submit the following to our Membership Department. A staff member will be in touch with you if there are any questions.

    Purchaser Name *

    Purchaser Email *

    Purchaser Address

    Recipient Name *

    Recipient Email *

    Recipient Address

    Delivery/Pickup Method *

    Payment form:

    Card will be mailed out upon receipt of payment, or can be picked up at 54 West Gate during regular business hours - Monday to Friday, 9:30 - 4:30.

    If you no longer wish to be contacted after submitting this form, please contact Jolene Plawicki, Interim Manager, at or 204 954-7880 (54 West Gate, Winnipeg Manitoba, R3C 2E1).

    Please read the privacy policy:

    I have read and agree to the privacy policy *