Menu
  (  Home
  (  Catalog
  (  Links
  (  Cover of
     "People"

On-Line Order Form

We accept . . . Visa & Master Card

Please fill in all available information below and hit the "Submit Your Order" button when you are done.
Thank you!
Note:
• Hit the Tab key as you complete each section to move to the next.
• Hit the Shift + Tab keys to go back.
• The ENTER key will NOT work when placing information on this form!

Your Information:

First Name
Last Name
Address
City
State      Zip
Telephone
Fax
E-mail


Using a Credit Card? *   Yes   No
Credit Card Number
Expiration Date
Visa or Master Card            Visa  M/C

* (For your protection: if using a credit card, this is Secure Web site If you still fill uncomfortable, send check or money order to the address below. Thank you!)

Please Ship To ( leave blank if same as above ) :

Ship-To Address
City
State      Zip
Telephone


Ship Via:

UPS Ground   UPS 2nd Day UPS Over Night   Other

Please fill in as much information as possible to help speed delivery:

Item No. Item Description  Qty.  Color   Price  Total
                                                                                                                                          Total Sale:  



Please enter any comments, color preferences, special instructions, etc., regarding your order:

Please contact us for:
Catalog · Catalog Information · More Styles
Pricing · Special Sales in Large Quantities


11937 Sunset Blvd. #C. · Los Angeles, Ca  90049

Tel:   310/476-3300   ·   Fax:   310/476-3300

E- mail:   hairjewelsla@aol.com

Back to Top          Back to Home