Hamsa Design Studio
75 N. Main St. #225
Willits, CA 95490
USA

Order Form:
This order form is NOT interactive!
(Ordering Information)...( Back to Home)

Cell  ....(707) 694-4005
Email eva@hamsa.com
http:// www.hamsa.com
 Name  Date
 Address
 City   State   Postal code  Country
 Telephone  E-mail  Fax
 Shipping Address (if different from above)

ID #
Description of Item:
(Please include type of stone, if applicable)

As Brooch

Picture in Locket

Qty.
 Unit Price  Total Price

14K Yellow Gold

14K White Gold
               
               
               
               
               
               
               
               
               
Special Instructions:

  TOTAL $

 
 Sales Tax, California add.......... 7 3/4 %  
 Insurance..$0.95 for each $100 of value  
 Shipping / Hand. US Priority Mail $4.95  
 US Priority Mail: Tracking $0.70  

 GRAND TOTAL $

 
Method of Payment by Credit Card:
Name as it appears on Credit Card:
Visa ____ Master Card ____   Expiration Date:
Card Number:
Expiration Date: Signature:
Phone :  Please give me a call about my Credit Card information: ______YES
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Copyright, Hamsa Design Studio , Eva Strauss-Rosen © 2012
Questions, Comments and Technical Problems: eva@hamsa.com