Constants and Variables: We Make Numbers Beautiful, Fine Jewelry and Necklaces

Custom Necklace Order Form - You Design

Congratulations! You have decided to order the most unique gift you can give to your special person or yourself!

To complete the form you will need to have the following information ready:

1. The date or special number you would like represented.
2. The type of clasp you would like. ( View Clasps)
3. The bead you would like to have represent your date or number in the necklace. These are called Number Sequence Beads. ( view all bead options )
4. The bead(s) (up to two types) you would like to have used as spacers to separate the digits in your number/date.
These are called Spacer Beads. ( view all bead options)
5. The length you would like the necklace.

Directions
1. Please complete the following form. REQUIRED FIELDS ARE BOLDED
2. No payment is due now. Once we receive your order, we will contact you to finalize payment.
We currently accept payment by money order, cashier's check or Paypal.
3. Once your payment is finalized, you will receive your new necklace within 10 business days.

1. Contact Information

Name

Address

City

State

Zip Code

Phone

Email

2. Necklace Information

Date to be represented in necklace:

(_ _/_ _/_ _ _ _) OR Number to be represented in necklace

Desired Length

If 'other' please enter length here:

Clasp

( View Clasps )

3. Date Bead Selection - Please select one bead to represent your special date or number:
The cost of your custom necklace is based upon the type of bead select below.

$99.00 Price Group	$149.99 Price Group	$229.00 Price Group	$329.00 Price Group
Agate Czech Glass Dalmatine Jasper Fancy Jasper Jade Onyx Onyx - frosted Poppy Jasper Turqoise	Amethyst Aquamarine Aventurine - Green Aventurine - Orange Carnelian Citrine Freshwater Pearl - ivory Freshwater Pearl - lt green Freshwater Pearl - peach Freshwater Pearl - Pink Freshwater Pearl - taupe Freshwater Pearl - white Freshwater Pearl - wine Garnet - Red Iolite Lapis Lazuli Moonstone Peridot Rhyolite Rose Quartz	Garnet - Green Opal Swarovski Crystal - Olive Tourmaline	Sapphire - orange Tanzanite