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ORDER / INQUIRY FORM

Krikawa Jewelry Designs, Inc.

Please select: Order Inquiry

Product Requests:

Engagement Rings and Wedding Bands

		Engagement Ring	Wedding Band 1	Wedding Band 2
Ring Design:
Base/Liner Metal:

	for mokume inlay rings:
Mokume Metal:
Rails/Edges:

Finish - Sheen:
Finish - Etch:
Ring Size:
Width of Band:		mm	mm	mm
Primary Stone:		Diamond:
		color: to
		clarity: to
		Natural Sapphire:

Cut:
Stone Size:		carat
Other/Accent Stones: (explain in Notes)		other stones	accent stone(s)	accent stone(s)

Other Products:

Notes:
(e.g. other details, specifications, requests, questions, etc.)

Full Name:

SHIPPING ADDRESS:

Address:

City:

State:

Zipcode:

Country:

CONTACT:

Telephone #:

home

work

I prefer to be contacted by (select one):

Email address:

(required)

phone

either

INTENDED METHOD OF PAYMENT: VISA MC Discover Check Money Order/Cashier's Check
[NOTE: This order form is not an automated purchase system. Each order is hand-filled and you will be contacted by the method of your choosing prior to billing.]

BILLING ADDRESS (if different from above)

same as credit card address? yes no

Address:

City:

State:

Zipcode:

Country: