Please fill out this form and we will contact you by phone regarding your order!
Item order#:
Choice of metal:
— Metal Type —
14K Yellow
14K White
Sterling Silver
Platinum
Choice of stone:
Finger size:
(Can be sent back for sizing after purchase at no charge)
Name as it appears on credit card:
Day time phone number:
(
)
ext.
E-mail address:
*Billing Address
Address:
City:
State:
Zip code:
*Shipping Address
(
Same as billing address)
Address:
City:
State:
Zip code:
*
Please use one order form for each item ordered.