JEWELRY ORDER FORM

Name of Piece___________________________________________
Size___________________________________________________
Price___________________________________________________$___________________
Illinois residents add 6.5% sales tax____________________________$___________________
Subtotal_________________________________________________$___________________
Shipping - Up to $150.00 = $8.00, Over $150.00 = $12.00____ _____$___________________
GRAND TOTAL__________________________________________$___________________

Indicate Method of Payment:
Check.(__), Money Order.(__)..( Make payable to Frank Hyden)
Visa.(__), Master Card.(__)

Credit Card Number__________________________________________
Exp.Date___________________________________________________

All orders sent by mail must be accompanied by a signed copy of this ORDER FORM.
The ORDER FORM can be printed out and sent with payment...(click on the ORDER FORM frame to select it before printing)

Signature___________________________________________________

DATE_____________________________________________________

Mail the signed ORDER FORM and Payment to:

Frank Hyden - Jewelry
623 Nash Road
Crystal Lake,Illinois - 60014

If you have any questions please feel free to E-mail me at...Frank Hyden - Jewelry
Or give me a call at (815)459-1849

Shipping Instructions:..(Where I am to send your order)...I use U.P.S. whenever possible.

Your Name:____________________________________________________
Your Address:__________________________________________________
Your City and State______________________________________________
Your Zip Code:_________________________________________________
Your Telephone Number (Optional):__________________________________
Your E-Mail address:_____________________________________________

All orders, except special requests, shipped within 2 weeks of receipt of payment.