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Starstone Order Form
Please fill out the form below and click on the submit button at the bottom.
You can also print a blank copy of this form and fax or mail it at your convenience.
Click here for blank form
The following information is required to complete your order for a
customized Starstone Necklace
.
Please fill out this section for the person who will wear the necklace:
First Name:
Birthdata:
Month:
January
February
March
April
May
June
July
August
September
October
November
December
Day:
1
2
3
4
5
6
7
8
9
10
11
12
13
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15
16
17
18
19
20
21
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25
26
27
28
29
30
31
Year:
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Hour:
12:00am(midnight)
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm(noon)
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
Minute:
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Birthplace:
City:
State or Province:
Country:
Chain Length:
14" XSM
15" SM
16" MED
16.5" Lg
Ship To:
Full Name:
Address:
Bill To:
Your Full Name:
Payment Options:
Visa
Money Order
Personal Check
I have paid through Paypal
* NOTE: Payment Options will be provided upon submitting your order.
Custom Starstone Necklace:
$75.00 each US
Comments:
Orders will be filled when payment is processed.
To send your order by secure email, click here:
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Mailing Address:
A STONE'S THROW
BOX 147
ARMSTRONG, B.C.
CANADA V0E 1B0
Phone #:
1-250-306-8891
Home
|
About Us
|
About Starstone Necklaces
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Order Starstone Necklaces
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Contact Us
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Links
© 2008 A Stone's Throw
site by:
LANiMedia.com