Order Form: 14K GF Name Necklace

Name on Necklace*
Select Name
Chain Length
The standard length for the chain is 18 inches. We can shorten it if this is a gift for a child.
Shorten chain?	No Yes
Billing Address
Name:*
Address:*
City:*
State:*
Zip:*
Country:*
Telephone:*
Email:
Shipping Address (if different from Billing Address)
Name:
Address:
City:
State:
Zip:
Country:
Telephone:
Email:
Shipping Method
We offer USPS Priority Mail for $6.00 (standard delivery is 2-3 working days) and USPS Overnight Mail for $17.00.
Please choose:	USPS Priority MailUSPS Overnight Mail
Total Price:
(Total Price = Necklace Price + Shipping Cost)
Credit Card Information
Card Type:*	Visa MasterCard American ExpressDiscover
Card Number:*
Expiration:*	Mo: January February March April May June July August September October NovemberDecember	Year: 2006 2007 2008 2009 2010 2012 2013 20142015
Name on Card:*
(Note: The charge to your credit card will say Simones Accessories, Seaside Heights, NJ.)
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