MAIL ORDER FORM:   CLICK HERE TO PRINT

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Name:_____________________________________________________
Address:___________________________________________________
__________________________________________________________
City:_________________________ State:__________ Zip:___________
Telephone:________________ E-mail:___________________________


Qty
Item #

Description

Price
Total
         
         
         
         
         
         
         
         

Shipping charges include postage, and insurance

 up to $49.99
Please add $5.50  

$50.00-99.99
Please add
$6.50  

$100.00-Over
 
Please add $9.50  

SubTotal:    
Mn Residents add 6.5% Sales Tax:    
Shipping/Handling:    
TOTAL:    


Please make Money Order/Check payable to:

Blue Moon Jewelry

 E-mail:
mail@bluemoonjewelry.com

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