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     Order Form

Use this page to order by mail, email, or phone. 

Shipping Information (if different than Billing)
Name Name
Address: Address:
City:                                             State:         Zip: City:                                             State:         Zip:
Country: Country:
Daytime Phone: Daytime Phone:
Email: Email:
 
  Item Number/Description Qty.

Price

 Subtotal
       
       
       
       
       
Ohio Residents Add 6.75 Tax:  
 Shipping & Handling:           3.85
 TOTAL  
                               
COMMENTS: If ordering name bracelets, be sure to include names and specifics to each item.
        
      

PLEASE MAKE CHECK OR MONEY ORDER PAYABLE TO: Vicki Johnson
Vicki Johnson
4171 LaRue-GreenCamp Rd.
Marion, OH 43302
United States
Phone: 740.528.2558
Fax: 740-528-2738 
vjohnson@beadifulgems.com


Name on Credit Card:
Billing Address:
 
Visa      MasterCard     
Number: ---
Expiration Date: -

 
 

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