Pumpkin Custom Candle Order Form

Pumpkin Custom Candle Order Form
Choose your essential oil scent(s)-up to 2

LavenderPink GrapefruitEucalyptusLemonCoffeeCinnamonPeppermintValorGardeniaSandalwoodJasmineFrankincenseHoneybellTropical PassionLemongrassArbor SaplingYlang YlangTangerineVetiverLemon VerbenaCitrus AgaveRosemary SageCotton Lime VerbenaMoroccan CashmereVanillaOrange
Choose the organic herb(s)- one is included

Lemon BalmLily of the ValleyHibiscus FlowersElder FlowerDandelion LeafHeatherLavender FlowerAnise SeedJasmine FlowerMugwortLemon VerbenaPapaya LeafGinger RootViolet Leaf
Choose your crystal chip topper- one is included

ObsidianRose QuartzAquamarineCarnelianRed JasperAngeliteGreen AventurineCitrineYellow AventurineOrange CalciteBlue Tigers EyeAmethystLapis LazuliLabradorite
Further customizations(would incur an additional fee), please fill in what you are looking for below:

Different Crystal TopperAdditional HerbAdditional Essential OilOtherAdditional Crystal Topper
These are standard to all my candles, do you want..?:

Wood wickClear Quartz on bottomCopper dust on topNon standard cotton wick
Further Customization Details: I would have to custom order, would add time to order and ship to me, along with the extra fees (dependant on choices). Would email approval and invoice before placing order.
Intention/Healing you want infused in? You can write this out exactly as you want me to say it or as general and I will word it myself.
All candles are $35 + tax, will adjust if optional customizations are requested. This does not include shipping. If you require shipping, I will add cost of this to the order before I send the invoice. Please write below if you will want shipping. Thank you!
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number
Date required (est time, if I have the ingredients you request on hand, it is a day to make plus 2 weeks of curing time. If I have to order items, could take an additional 1-3 weeks depending. I will do my best to fulfill your timeline.)

MonthDayYear
Date
Should be Empty: