Order Form
Please print out this form, list the pieces you want, and return the form with payment to:
Diana’s Jewels
Shirley Diana
Starke
3408 120th
Ave. SE
Valley City, ND 58072
|
Title of item as
it appears on page |
How Many |
Price Each |
Total Price |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Postage: $1.50 for the first item, $.25 for each additional |
|
||
Insurance: $1.30 (optional for costume jewelry; required for genuine) |
|
||
|
Total Enclosed |
|
||
We pay the
additional insurance for orders over $50!
Name:
Address: