ORDER JEWELRY

(510) 912-6508

Any Questions please send an email

E-mail A Fantasy of Jewels

If ordering by check

Retailer

or

Using a Money Order

FILL OUT THIS FORM

Upon receiving your order I will reserve each piece for you. Once your check has cleared your items will be sent. Money order purchases will be sent immediately upon receiving money order.

Name *
E-mail Address *
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Phone *
Retail Tax No:
List Items to be reserved: give Item No. and Amount *
Total No. of Items Reserved: *
California Resident *	Yes No
California residents, please add 8.25% sales tax
Total Amount of Purchase
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