Water Music Jewelry Memory Order Form

If you want to email your form, please fill out the form below and the hit "submit" button. We will call you to confirm your order once we receive it and for payment.

If you want to fax your order, please...
1. Complete and print this page
2. Fax it to us at (715) 779-5262
3. We'll call you to confirm the order once we receive it and for payment.

If you want to mail us your order, please...

1. Complete and print this page
2. Mail it to us at P.O. Box 1412, Bayfield, WI 54814
3. We'll call you to confirm your order once we receive it and for payment.

Thank you for your order.

Name

Mailing Address

Daytime Telephone

Email Address

Fresh Jewelry:

Jewelry Item No.
Jewelry Item No.
Jewelry Item No.

First Memory Bracelet style (choose one):

Lake Forest Garden Night Sky

First size (choose one):

Small, 7.25"Medium, 7.5"Large, 7.75"

Other, specify here

Second Memory Bracelet style (choose one):

Lake Forest Garden Night Sky

Second size (choose one):

Small, 7.25"Medium, 7.5"Large, 7.75"

Other, specify here