Jemma Jewelry Order Form

Use this form if:

- You are placing orders from outside the continental US
- You are not comfortable conducting payment transactions online and would prefer to pay via COD, Money Order or Check
- You would still like to use PayPal, but cannot (or would prefer not to) process your order through the online catalog

1) Provide your name, e-mail address, phone number and shipping information.
2) Please indicate what items you would like to order.
3) Indicate desired payment method
4) Indicate desired shipping method
5) Submit the form
6) You will receive an e-mail to confirm your order details along with total cost, including shipping & applicable taxes. You will also receive instructions on how to process your payment.
7) Once your payment is received, we will confirm this by e-mail and notify you when the items are shipped.

* Required Fields.

Full Name *
E-Mail *
Tel.
(+ area code)		 *
Address

*

  *
City *
State or
Province		 *
Zip or
Postal Code 		*
Country *
       
Item # Description Color
(if applicable)		 Price

 

Questions, comments or special requests

 

PAYMENT METHOD (choose one)


(USD funds)
(USD funds)

SHIPPING METHOD (choose one)




This form is not a secure medium for communication. Any confidential, proprietary, or sensitive information transmitted by a user by means of this form may be read and copied by unauthorized persons. Please do not include account numbers, credit card information, or any other sensitive financial information which could be intercepted by a third party.


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