Raymond Jewelers - Mail Order Form

Customer Information

Name:
Email:

Billing Address

Street:
City:

State/Province:		Country:
ZIP/Postal Code:		Phone Number:

Shipping Address

Same as Billing

Street:
City:

State/Province:		Country:
ZIP/Postal Code:		Phone Number:

Order Information - Please select available gold and/or gemstone colors for your item(s).

Item SKU Number	Item Name	Gold Color	Size	QTY	Raymond Jewelers' Price

Sub Total:
Connecticut Residents add 6% Sales Tax:
Shipping:
Grand Total:

Shipping Charges

USPS First Class Mail FREE	USPS Global Express (Canada) $20.00
USPS Priority Service (3-4 days) $12.00
USPS Express Mail 1-2 Days $20.00

Payment Information

Please make your Check or the Money Order payable to: Raymond Jewelers If payment is by personal check, your item/s will ship only after your check has cleared our bank. (7-14 business days) Cashier's Check or Money Order will be processed immediately.
Additional Comments:

Please fill out this form, print it out and mail to:

Raymond Jewelers

1449A New Britain Avenue

West Hartford, CT 06110

Attn: Online Services

Toll Free Phone: 1-866-561-3971


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