ISELAGRACE | Jewelry for the Spirit

Please fill out the information below to place an order. Patricia Connors will call you to collect your payment (credit card number or check). All information collected will remain strictly confidential. ASTERISK ITEMS ARE REQUIRED FIELDS.

PERSONAL INFORMATION
Name*		Email*
Address*
City*		State* Zip*
Phone 1*		Phone 2
The best time to contact you is
JEWELRY ORDER
Jewelry Name		Item Number
Jewelry Name		Item Number
Jewelry Name		Item Number
Jewelry Name		Item Number
Jewelry Name		Item Number
OPTIONAL INFORMATION
How did you hear about Iselagrace Jewelry?
List some of your jewelry preferences (gold, silver, turquoise, etc.)
Your birthday (for special discounts)
Share the joy and refer a friend to Iselagrace! (please list email addresses)
Comments or Questions