Custom Order Form

* Please provide as much information as possible

Order Type: *

Place A Special Order

Request Renders

Role Type*

Choose Store Location:*

Store Sales Executive Name:*

Store Sales Executive Email:*

Your PO#:*

Additional contact Number:

Your Name: *

Account Number:

Expected Delivery Date:

Shipping Speed:

Request a Wax Sample: ($30) [Fees Applicable]

** This will be used if your request is based on one of our existing styles)

** Min size 3.00 and maximum 14.75. Enter values in 0.25 increments.

Miligrain

Engraving

** Preferably in MM size or in CT weight

** ( Side Stone/ Melee information)[# of stones, size, MM size, Total weight etc..]

Store/Company Name: *

Email Address: *

Phone Number: *

Submit