Gift voucher

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A Beleko voucher in 1,2,3

1. Order your gift voucher with the form below,
2. Pay the correct amount into the back account number you will receive per email,
3. We instantly send the voucher to the listed address,

You can order a gift voucher with this order form. You decide on the amount or treatment you would like to give. The voucher is valid for 6 months after purchase.
You can also send an email with all the information to info@beleko.be.

The cases with an * need to be completed.
Name giver*:  
Name receiver*:  
Amount or treatment*:  

Where can we deliver the voucher?
Street*:    Nr.*   
Postal code*:    Town*   

Your email*:   
Your phone nr.*:      

Reason*:  
Other reaseon:
 

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Beleko Bvba
Health & Beauty Clinic
Amerikalei 90
2000 Antwerpen
03 257 72 27
info@beleko.be

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