| DATE: |
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| COMMENTS: |
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| EMAIL: |
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| NAME: |
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| ADDRESS: |
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| CITY, STATE AND ZIP: |
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| TELEPHONE: |
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| ITEM NUMBER: |
|
| TYPE OF JEWELRY (earrings, necklace, bracelet): |
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| TYPE OF BEADS: |
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| COLOR (s): |
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| TYPE OF CLASP/EARRING TYPE: |
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| SIZE AND /OR EXTENDER(?): |
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| NAME BRACELETS (see description of bracelet for prices) |
(Up to five letters per bracelet included in price, add $2.00 per
letter for more) |
| Letters: (lg rounded block, sm rounded block, square, or engraved): |
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| FIRST NAME: |
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| SECOND NAME: |
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| THIRD NAME: |
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| FOURTH NAME: |
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| SHIPPING AND HANDLING $4.50 SENT PRIORITY MAIL |
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| DELIVER TO: |
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