Custom Order Form

Contact Info

Company Name (Required):

Contact Person:

Phone Number:

Email Address:

Bill To:

Order Details

PO Number: (Any alphanumerical combination you would like to keep track of this order.

Deadline Date (Example: May 15, 2018):

Finger Size (Required):

Metal Type (Required):

Center Stone Detail:

Attachments (Optional):

Detailed Info (Required)

Customer Information (Optional, only If you want DeLeo Jewelry to send to your customer)

Customer Name:

Customer Address

Customer Phone Number:

Fedex Number (if necessary):