Family Jewelers .Com

Product Order Form


INSTRUCTIONS :
  1. Print this order form using your browser's print option. 
  2. Complete the personal information including your name, address, and phone number(s). 
  3. Fill in the item #, quantity, unit price, and total. Add in the sales tax (if applicable) and the shipping and handling fee to the total. 
  4. Select a payment method. 
 Please  Mail or Fax the form to:
Family Jewelers.Com
5000 W. Esplanade Ave. PMB #107
Metairie,  LA.   70006

Fax :   504-779-7554
Tel. :   504-887-3331 

(Appropriate delivery and shipping information will be provided at time of purchase.)

(Allow two weeks for delivery of  items)
Name: _________________________________________                 Date ___________
Address:_________________________________________ 
City:__________________________________State:______     ZIP:__________
Home Phone:  (______) _________________ 
Work Phone:   (______) _________________
E-mail Address: ________________________
Payment:  Cashier's Check _____  Money Order _____  Personal Check ______
ITEM #
DESCRIPTION
QTY 
UNIT PRICE
 AMOUNT 
        $ 
        $ 
        $ 
        $ 
        $ 
Shipping & Handling: Please add $6.00 for order up to $200.00., $8.00 for order up to $500.00. ,  $10.00 for order up to $1000.00., and  1.50%  for order over $1000.00 $
Please add 8.75% sales tax for La only.
 $
TOTAL:
 $

As thanks for visiting our site please accept this
FREE GIFT VOUCHER
(Click Here)
Please tell your friend about us and have them get one too!

Contact Information

Gary & Rosemary Fortmayer

Email Us
Phone: 504-887-3331    Fax: 504-779-7554


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