Pet Jewelery Store - Order Form | Star Gems Inc

770 394 6727

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Star Gems Inc In Norcross

3850 Holcomb Bridge Rd., Suite #205, Norcross, GA - 30092

3850 Holcomb Bridge Rd., Suite #205, Norcross, GA - 30092

Pet Jewelery Store - Order Form

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PET JEWELERY STORE ORDER FORM

Order Date

Store Name *

Contact Person Name *

Cellphone # *

Address *

City/State/Zip *

Store Phone # *

Email id *

ALL CONTRACT ARE FOR 1 YEAR & RENEWABLE ON 1 YEAR BASIS

APP PACKAGE

Package

Price

Order

One Time Setup Fee

$100.00

Monthly Charges

$20.00

PAYMENT DETAILS

Method Of Payment (select one) *

AMEX MasterCard Visa

Account # *

Expiry Date *

CVV Code *

Name as it appears on the card *

Address where card is registered *

Word Verification*

Note:

Free 2nd day Shipping
$75 Cancellation fee if CAD is done and order not processed in 30 days*
If same CAD if processed after 30 days then $75 will be refunded in the order

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