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Custom Order Form

* Please provide as much information as possible

*Order Type:

Place A Special Order

Request Renders

*Choose Store Location:

*Store Sales Executive Name:

*Store Sales Executive Email:

*Your PO#:

Additional contact Number:

*Your Name:

Account Number:

Attach Photo or File:

Add More Attachments

Expected Delivery Date:

Shipping Speed:

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

Product Information:

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

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

Metal Type:

Metal Color:

Metal Wt:

*Shank Design:

Polish:

*Center Stone Type:

Center Stone Shape:

Center Stone Size: ** Preferably in MM size or in CT weight

*Diamond Quality:

Are you sending the Center stone for Setting?

Are you supplying Melees?

Melees

*Color Stone Type:

Stone Quantity:

Diamond Count:

Color Stone Count:

Diamond Wt:

Color Stone Wt:

Miligrain

Engraving

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

Ordered For

*Store/Company Name:

* Email Address:

*Phone Number:

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