Mailling Address..................

City.....................................

Zip

State...................................

Item Number(s)...................

Total Amount..................US$

Plus

Items will be on hold after received your
Check/Money Order Jewelry will be
shipped on received of payment.

California Residents: Total + 8.25 % Tax Charge
U.S. Priority Mail: $4.50  Within 3 Days Delivery
Express Mail:  $10.75   Next Day Rush Delivery

Full Name............................

Phone No. of Card Holder...

Check or Money Order No.

Exit here after submitting Form