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If
ordering earrings, please indicate whether you prefer
pierced or
clip-on style.
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Subtotal: |
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$
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Tax:* |
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$
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Shipping:** |
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$
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$
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| Payment
may be made by check [made out to Ms. Collette Fortin], by
money order [made out to Ms. Collette Fortin], or by credit
card. We do not accept credit cards over the Internet. Please print
out a copy of this completed form and mail it to: Ceiba Tree
Jewelry, 118 Gull Dip Road, Ridge, NY 11961. By pressing the
"Submit" button below, you may send this form electronically
to Collette at the same time you print the form and mail your payment.
However, this is not a secure connection, so I ask that you please
do NOT send your credit card information over the Internet. If you
choose to pay by credit card, please include that information, with
the expiration date, on the printed form. If you pay by check or
money order, please make the check or money order out to Ms.
Collette Fortin. |
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| Payment
by: |
Check
Money Order
Mastercard
Visa
Credit Card No:
Expiration Date:
Signature:
__________________________________________
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Please
fax your completed form to me at (801)
340-4648;
or mail it to:
Ceiba Tree Jewelry
118
Gull Dip Road
Ridge, NY 11961.
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SPECIAL
ORDER: In the space below, please tell
me what kind of design you would like. Select the style, metals (gold,
sterling silver, copper, brass), the type or color of the gemstone you
would like (if any), and provide as detailed a description as you can.
If you are sending a hard copy, please include a sketch of the piece.
I will then contact you and we can create the jewelry piece of your
dreams.
You may fax
your completed form to me at (801)
340-4648; or mail it to:
Ceiba Tree Jewelry
118
Gull Dip Road
Ridge, NY 11961.
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