Bracelet Information Order Form...build your bracelet
PLEASE TYPE IN YOUR RESPONSE...
THANK YOU
**All Required Fields
**Your Name:
**Your E-mail: address:
and/or
Your phone number:
Shipping Address:-if not
paying with Paypal:
City, State, Zip Code
**Bracelet Style# of Choice:
If choosing Pendant or Watch,
type in Style No.#  for it.
**How many photos are you:
sending?
**How are you sending your
photos?  By E-Mail or by U.S. Mail?
Name your choice of Crystal and
Color for that style?...If applicable:
**Choose one...
Color Photos or Black & White:
**Choose one...
Wavy Edge or Straight Edge Tiles:
**Choose one...
Vertical or Horizontal Photos:

Please note: if you have
several people that you want in
a photo then the Horizontal
photo will be used for the
whole bracelet.
Bracelet Size: See bracelets
page for sizing instructions.
**Please choose your  payment option:   
Paypal, Money Order, Cashiers Check,
Local Check or Gift Certificate (if gift
certificate please type in cert# number.

Please Note: Payment must be received
before order can be processed.
Thank you.
Special instructions or
message:

(This may include using
only one person in a
photo or maybe sending
an extra photo just in
case one is not good
quality, etc...)
Thank you for your order...I will confirm your order by e-mail or by phone.
Payments Accepted:

  • PayPal Preferred
  • Money Order
  • Cash
  • Local Check
  • Gift Certificate
If I am mailing your items
to you,
$5.25 will be added
to your total for
postage-shipping/handling
and to ensure proper
packaging before mailing it.
Thank you.
E-mail pictures to:
joannew5@sbcglobal.net
PayPal Accepted
     PayPal Verified       
If paying with Pay Pal,
please submit payment
after placing order.


Orders can only be filled
after receiving payment.

Thank you.
If mailing your photos please
contact me for my
mailing address.