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Barbara Zarcone – Independent Jewelry Consultant
Website
Catalog
Submit
Order Form
Name:
Address:
City:
ST:
Zip:
Email:
Home Phone:
Cell Phone:
Hostess:
Party Date:
Item Number
Size
Page #
Item Name
Quantity
Cost
Total
THANK YOU FOR YOUR ORDER
Total:
CASH OR CHECK PREFERRED
Shipping:
CHECK PAYABLE TO:
Barbara Zarcone
(908) 672-3979
Subtotal:
barbara4jewelry@gmail.com
barbarazarcone.mypremierdesigns.com
6.875% Sales Tax:
(Required by law)
Total Due:
Please complete ALL information below if paying by credit card (Mastercard or Visa only)
Credit Card #:
Expiration Month:
CCV (3 digit code on back):
Billing Zip Code:
Approval Signature:
/ Year:
BZ Premier Designs Order Form TEST_distributed_0001.pdf (PDF, 200.16 KB)
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