Mail in your order print out the following order
form and Mail it to:
Beverly Johnson
63 Columbus ave Farmingville,
NY 11738 | Name:_______________________ Email:_______________________ Company
(optional):____________ Address:_____________________
____________________________ City:________________________ State:_______________________ Country:_____________________ Zip:________________________ Phone:(____)
_____-_______ (__) I am enclosing a check or money
order for $______
make all checks payable to Beverly Johnson.
(__)
I want to charge this purchase to my credit card. (__)VISA (__)Mastercard
Card Number: __________________ Expiry Date:____________________ Signature:
______________________ I authorize Patriotic-Jewelry.com
to charge this amount: ______________ |