Custom Jewelry Design Order Form
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Name (Last, First)
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Email
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Phone #
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What kind of gemstone jewelry piece are you looking for?
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Earrings
Necklace
Bracelet
Ring
Hair Accessory
Necklace and Earrings Set
Other:
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Please tell me about your favorite gemstones
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(Choose all that apply from the list below). I've listed only a few of my most commonly used stones, but please feel free to indicate any I missed under "other"
Labradorite
Citrine
Aquamarine
Rose Quartz
Chalcedony
Lemon Topaz
Blue Topaz
Smoky Topaz
Emerald
Ruby
Sapphire
Peridot
Onyx
Jade
Lapis Lazuli
Other:
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Is this item for a gift? If so, please tell me a little bit about the recipient.
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What is your budget for this order?
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This will help us determine what materials we should recommend for your piece.
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When would you like to have the piece ready?
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Would you like this order shipped or do you want to pick it up?
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Shipped
Pick-Up
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