Custom Jewelry Order Form
Client Contact Information
Date
-
Month
-
Day
Year
Date
Full Name
*
First Name
Last Name
Phone Number
*
Text Okay?
*
Yes
No
E-mail
*
example@example.com
Would you like this Item shipped directly to you?
*
Yes, I will pay the shipping fee to have my custom order shipped to my house
No, I will pick up the jewelry in studio
Delivery Address - (please fill out only if you would like your item shipped)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please understand that we are at the mercy of our jewelry companies wait times. Though we try to give our best guess as to how long orders can take, wait times and jewelry availability can change how long special orders can take. Your patience is much appreciated!
*
I understand
Back
Next
Jewelry Details
Manager or Counter Staff
Select one of the following
*
Please Select
Special Order
Custom Order
Group with Shop Order
Out of Stock Item
Jewelry Description or Name
*
Mechanism (threadless/threaded)
*
Gauge
*
Material
*
Gems/Colors
*
Setting
*
Length/Diameter
*
Quantity
*
Piercing Location
*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Notes
Date
*
-
Month
-
Day
Year
Date
Are there more parts to the order?
*
Yes
No
Counter Staff or Manager
*
Submit
Should be Empty: