Bespoke Questionnaire - Full Questionnaire

Your Name:*

NameSurname

Phone Number:

Country CodePhone Number

Email:*

Address:

Line 1

Line 2

CityCountry

ZIP CODE

Date of birth / Time of birth:

AM/PM Option

Place of Birth:

Do you wear jewellery?

If yes, how often and which kind?

Is there a specific kind of jewelry you are looking for (pendant, collar, ring, bracelet, earring, cufflink, crown, etc.)?

Are there particular metals or materials you prefer?

What's your favourite colour/s?

When you dress up do you prefer patterns or neutral colours?

What's your favourite colour of gold?

What is your favourite accessory?

Is there a specific reason or purpose you want to realise this jewel?

Do you believe in the healing properties of crystals and minerals?

YESNO

Are there specific crystals you are attracted to?

If yes, which one/s?

Religion [if any]:

Do you have any personal spiritual belief?

Please express as much or as little as you feel like.

Which is the most significant experience of your life?

We would like you to describe it.

Have you ever lived episodes of expanded consciousness or mystical experiences?

If yes, please share as much as you please.

Have you participated in hypnotic sessions or had trance-like experiences before?

If yes, share as much as you please.

Do you participate in psychotherapy or any form of analysis?

If yes, share as much as you please.

Do you have any recurrent dream?

If yes, we would like you to describe it.

What is your biggest desire or aspiration?

Do you feel you need to change something in your life?

If yes, share as much as you please.

Do you believe in the power of manifestation and that you can achieve anything you believe in?

Please express as much or as little as you feel like.

What is your consideration regarding energy and matter?

Please express as much or as little as you feel like.

What is your relationship with visual arts?

Please express as much or as little as you feel like.

Do you have any symbol you are particularly attached to?

If yes, which one/s?

What is your relationship with music and sounds?

Please express as much or as little as you feel like.

Are you fond of animals? Do you particularly prefer or identify with any?

What is your relationship with nature?

Please express as much or as little as you feel like.

Do you feel particularly attached to a person or any living being, whether currently living or not?

If yes, share as much as you please.

Are you fascinated by any particular culture?

If yes, which one/s?

Are you fascinated by any specific time and place in history?

If yes, which one/s?

Is there any divine, religious, historical, mythological or fantasy character you feel devoted to or simply fascinated by?

If yes, which one/s?

Is there any other entity, concept or element you are fond of?

If yes, which one/s?

Do you have any experience with holistic medicine?

If yes, please share as much as you please.

Do you participate in meditative practice (transcendental, vipassana, loving-kindness, mindfulness, any type of yoga, tai chi, qi gong, etc.)?

If yes, please share as much as you please.

Do you practice sport, martial arts or any form of physical exercise?

If yes, which one/s?

Have you ever partcipated to any form of ritual or ceremony?

If yes, please share as much as you please.

Do you believe in fortune or destiny?

YESNO

Do you participate in any kind of fortune consultation (tarots, crystal ball, turkish coffe, fortune teller, etc.)?

If yes, please share as much as you please?

Do you believe in numerology?

YESNO

What's your favourite number?

Do you believe in astrology?

YESNO

Do you know your star signs?

First sun, second rising, third moon.

Would you like us to read your astral map and numerology study?

YESNO

Do you have any material (gold, gems, etc) or pre-owned jewellery would you like to recycle for this piece?

If yes, please describe the products.

Now we would like you to think about an intention you would like to associate with your personal creation. You can keep it for your self or write it down and share it with us. What is importantis that is truly meaningful for you.

What's the budget for this jewellery piece?*

in Pound sterling £

DISCOUNT CODE

At Supera Jewels we hand over our pieces through Ceremonies meaningfully customised in order to evoke beneficial emotions and promote energetic balance. We introduced Ceremonial Experinces and Private Retreats in different locations around the world, to consciously facilitate the infusion of intention in the crystal, the energy-trapping core of our jewels. We integrate fire rituals, breath-works, different kind of meditative practices, cleansing procedures, sound journeys, theatrical performances, ritual dances, art exhibitions and much more to shape a tailor made experience that is meant to empower an energetic bond between the jewel and the receiver.

Type a question

I would love to know more about the Ceremonial Experineces.I would love to know more about th Private Retreats.No, I’m fine with the Jewel.

We highly appreciate your collaboration, thank you!

We retain the right to refuse the bespoke order or add you to a waiting list. In both cases you will receive a communication via email. Once the order is confirmed, we will get in touch with you within 1 week to submit the first design ideas.

By signing and submitting this form I declare:

I agree to pay a deposit 25% of the budget or anyway not higher than of 600,00 £ to cover the costs of consultation, research and preliminary design.

The deposit must be transferred within 24 hours after receiving the confirmation email with acceptance of the bespoke order, to the following bank details:

SUPERA JEWELS LTD

Account number: 22217198

Sort code: 04-06-05

IBAN: GB12CLRB04060522217198

SWIFT code: CLRBGB22

Beneficiary address: 79 SAFFRON HILL, EC1R5BU, London, United Kingdom

If the confirmation arrives later than 2 weeks, you'll be asked to reconfirm your order.

I agree with the TERMS AND CONDITIONS OF SERVICE as specified on SUPERA JEWELS's website (https://superajewels.com/)

I consent to SUPERA JEWELS Ltd storing and using all the personal
informations, which I shared in the Bespoke Questionnaire, exclusively for
the customisation purposes of the Bespoke Jewel, the gadgets and the
Ceremonial Experience or the Private Retreat which accompany the
bespoke jewel and, in any case, accordingly to our PRIVACY POLICY
(https://superajewels.com/pages/privacy-policy).
I understand that the customisation purposes include sharing these
informations with: the Design and Manufacturing team for them to carry
out any activity related to the personalisation of the bespoke jewel or
intended to recollect, partially or integrally, the informations shared with
us; the Creative team for them to carry out any activity related to the
personalisation of the gadgets and other contents consigned with the
jewel of during the Ceremonial Experience or the Private Retreat; all the
internal and external personnel involved in any activity necessary for the
proper set up and execution of the Ceremonial Experience or the Private
Retreat; any other internal and external collaborator involved in any
activity necessary for the finalisation of the design, manufacturing or
crafting of the bespoke jewel.
These informations includes identity data, contact data, financial data and
all the other sensitive personal data shared with SUPERA JEWELS Ltd
filling the form.

Contacts
After reviewing this policy, if you have additional questions, want more information
about our privacy practices, or would like to make a complaint, please contact us by
e-mail at info@superajewels.com or by mail using the details provided below:
79 Saffron Hill , EC1R 5BU.

Complaints
If you have complaints about how we process your personal information, please
contact us using the contact details provided above. If you are not satisfied with our response to your complaint, depending on where you live you may have the right to appeal our decision by contacting us using the contact details set out below, or lodge your complaint with your local data protection authority.

Sign*