*Please note: If any of your items are custom orders or jewelry requests please submit a request form for either of the two prior to filling out this form.  If I have responded to you request and have guaranteed I will be able to fulfill your request you can add the order to this form.  I don't want anyone paying for something I haven't guaranteed I will be able to make or not.

Date:

Customer Name:     Customer E-mail Address:

Billing Address 

Bill To Name:     Street:     City:    

State:     Zip Code:    

Type of Payment:  Personal Check:     Cashiers Check:    Money Order:      Cash:     PayPal:    Other:

Is your shipping address the same as your billing address? Yes No

If not, please fill in the shipping address information below

Shipping Address

Ship To Name:     Street:     City:

State:     Zip Code:

Please Enter Any Coupon Codes Here:

Desired Shipping Method: RWU Pick Up (FREE) OVER $25.00 TOTAL FREE SHIP USPS First Class USPS Pirority Mail FedEx Standard

(Please refer to the shipping table on my website for shipping charges)

Product #1

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #2

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #3

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #4

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #5

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #6

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #7

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #8

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #9

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

Product #10

Item Number:       Is This Item a Custom Order: yes no      Price Per Item:

*If you are ordering more than 10 items, please fill out the box below with the other item's information.

Subtotal: