Printable Order Form

Heritage Beads Printable Name Bracelet Order Form

Mail Order to: Heritage Beads, 8410-D Streamview Dr., Huntersville, NC 28078 Or Call: Toll Free (866)-393-2052 to order (9am to 8pm EST)
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Billing Address
(Purchaser)

Name:
Address:
City:
State:
ZIP:
Phone:
E-mail:

Shipping Address
(If different than billing address.)

Name:
Address:
City:
State:
ZIP:
Phone:
E-mail:

Style name or number: _________________ Price (or base price) ___________
Size: ______________ (See Wrist Size and Measurement Instructions) Size Adj: ________
No. of Strands: One (Base) ____ ; Two (+$40) ____ ; Three (+$80) ____ ; Four (+$120) ____

1st Name(s): ______________________ Birth Month(s): __________________________

2nd Name(s): ______________________ Birth Month(s):___________________________

3rd Name(s): ______________________ Birth Month(s):___________________________

4th Name(s): ______________________ Birth Month(s):___________________________

Notes: Shipping and handling (S&H) is free - USPS mail. Applicable sales tax will be collected from North Carolina residents.

Payment Methods
Visa ____ Master Card ____ Discover ____ American Express ____
Name on Card: _____________________________ Card Number: _____________________________________ Expiration date: _____ / _____ CVV# (on back of card): ______ What's this? Signature _________________________________________
To order by phone, call 1-866-393-2052 9:00 am to 5:00 pm EST M-F Please make checks or money orders payable to: Heritage Beads