Love Lori Michelle Jewelry
Wholesale Order Form
Placing An Order:
Please fill out the short form below. Upon submitting, you will receive a confirmation email that I have received your order (usually the next business day) and an estimated shipping/fulfillment date. You will NOT be charged at the time of order placement.
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Store Name:
*
Delivery Address (where the order will be shipped)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Phone Number
*
Please enter a valid phone number.
Items To Purchase (please list 1 per line)
*
Payment Info:
Your Credit Card info is securely saved at time of order placement. Your order will NOT be charged until the shipment of order occurs. Purchaser agrees to pay shipping charges.
Credit Card #
*
16 digits, no spaces
CC Expiry Date
*
MM/YY
CC 3 digit code
*
located on back of card
CC Billing Zip Code
*
5 digits
Requested Delivery Date
*
As Soon As Ready (typically 3-4 weeks)
On Date - please select below
Select Requested Delivery Date (-OR- select "As Ready" Above)
-
Month
-
Day
Year
Date
Please Include In My Order: (free, upon request)
Small Black Velvet Jewelry Bags
Small, Individually-Wrapped Jewelry Polishing Cloths
Love Lori Michelle Business Cards
None of the above
Order Requests/Comments
Please Sign Below
*
Submit
Love Lori Michelle Jewelry
1339 Glen Dell Dr ♥ San Jose, CA 95125
orders@lovelorimichelle.com ♥ www.lovelorimichelle.com ♥ 443-745-2606
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