Query

To Make an Order, Fill in the form below with the photograph copied from our site or rough sketch of the design in your mind and the price you can offer. In the Terms column, fill in other requirements like quality and required weight or carat of individual thing.

In the Notes column, fill in changes that need to be made in the design or anything that need special attention.

For Further Enquiry, do feel free to contact us

Purchase Order

OrderNumber

Date Ordered: *

Enter the date in MM/DD/YYYY format.

Date Required: *

Enter the date in MM/DD/YYYY format.

Submitted By/ Shipping Information

Name: *

First,MI(Optional),LastName

Address Line1: *

Street Address

Address Line2:

Street Address2 (optional)

City: *

State: *

Postal Code/ Zip: *

Zip Code

Country *

Email Address: *

Email Address

Telephone Number: *

Home or Business Telephone Number

Fax Number:

Home Fax Number

Order List

Item Number *

Photograph *

Give photograph of item to be made

Quantity *

Price offered *

Add Item

Additional Information

Terms

Notes

Any Additonal Justifcation or Exceptional Circumstances

Signatures

Date *

Signature *

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@font-face{font-family:yola_heading_font;src:url("resources/vanessa.ttf");}Order Form

Order Form