Order Form

To make a purchase, please follow these simple directions...


(1) Fill Out the Top Portion of the Order Form Using Your Computer
(2) Print The Order Form (Don't Worry, It Will NOT Print the Purple Background)
(3) Fill Out the Table Using A Pen ( Please Print!)
(4) Send The Order Form And Check or Money Order to:
Treasure Box
P.O. Box 157
Chesterfield, VA 23832



FREE Candle With Every Order! _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Mr. Mrs. Ms. Dr.

First name

Last name

Address

City, State, Zip

If you are ordering necklaces- What is your necksize in inches?

If you are ordering bracelets- What is your wrist size in inches?

Check money order

Bracelet

  Bracelet  

       Or  

  Necklace

  Dominant 

   Color #

  Recessive

   Color #

    Style

    Name

           Quantity

     

     Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 If you are ordering pre-made jewelry instead or in addition to custom made

 jewelry, please fill out this table also. If you are not ordering pre-made jewelry,

 please continue to this table anyway and add shipping to your order.

Item Number

             Description (color, style, etc.)

Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                    Shipping:

3.00

 

                                                          Total: