Bespoke 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?

Are there specific crystals you are attracted to?

If yes, which one/s?

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.

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 have any symbol you are particularly attached to?

If yes, which one/s?

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

The information you shared with us are already sufficient to create preliminary designs to submit to your attention. Although we highly suggest to increase the level of customisation in order to help us come out with creative ideas that would satisfy your wishes and match your style. Please select one of the options below to follow up with the creative process:*

Send me the Bespoke Questionnaire - Level 2Book a call to discuss further my bespoke order.Book a consultation using the Software C.I.E.M. (consciousness information energy matter) to identify which crystals, frequencies and remedies resonate more with my intention.No, I’m fine with this level of customisation.

At Supera Jewels we hand over our pieces through Ceremonies meaningfully customised in order to consciously facilitate the infusion of intention in the crystal, the energy-trapping core of our jewels. We can organise Ceremonial Experinces and Private Retreats in different locations around the world, accordingly to your desires and wishes. 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.

Do you wish to get your bespoke creation delivered during a Ceremonial Experience or Private Retreat?*

I would love to learn more about the Private Experiences.I would love to learn more about the Private Retreats.No, I’m fine with the jewel.

We highly appreciate your collaboration, thank you!

We retain the right to refuse the 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

LOCAL PAYMENTS:

Account number: 22217198

Sort code: 04-06-05

SWIFT PAYMENTS:

IBAN: GB12CLRB04060522217198

SWIFT code: CLRBGB22

SEPA PAYMENTS:

IBAN: GB79TCCL00997915472831

BIC: TCCLGB31

Bank Address: 12 Steward Street, London, E1 6FQ, United Kingdom

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 understand that the information shared in this form are sufficient to create a bespoke jewel with a basic level of customisation, and that Supera Jewels can create design ideas only equal to the level of customisation I choose.

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
Private Experience or the Healing 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 Private Experience or Private Retreat; all the
internal and external personnel involved in any activity necessary for the
proper set up and execution of the Private 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*