Order keepsake designs using this form.
Ordering is a two-step process. First, create your shopping cart. This totals the prices for your order and charges your credit card or bank account. Then, send me an e-mail or print, fill in, and mail me this order form to give me the details as to how to make your pieces, including charms, clasp and other choices.
This two-step process ensures your pieces are made correctly, and allows you the flexibility to customize your order.
You may mail in payment by check or money order if you do not want to pay on the internet.
Orders will not be processed until payment is made.
Mail: Megan Brown / 134 Shipper Ct / Martinsburg, WV 25404
Name: ___________________________________________________________
Billing Address: ____________________________________________________
_________________________________________________________________
Shipping Address: __________________________________________________
_________________________________________________________________
Telephone Number OR E-mail (I need a way to contact you with questions about
your order): ______________________________________________________
Circle the items you want, matching this information with your shopping cart purchases. If ordering more than one item you may continue on the back of the printout, in legible handwriting, remembering to include all of the below information when describing your pieces, or you may print more than one copy.
Circle when applicable:
Item:
Bracelet Necklace Pendant Watch (with pink & blue)
Watch (with pearls only) Earrings Keychain Suncatcher
Cell Phone Chain Hemp Bracelet
Quantity: ____________ Length: ____________
Your Story, for personalization of your piece: if you choose to share it
Depending on the piece you order, some of this information will not be needed. All information helps me make a piece designed especially for the child you are remembering.
Baby's Name: __________________
Baby's Gender: _________________
How far along when the baby died (number of weeks pregnant),
or child's age: ______________
Birth Month: __________
Month of due date: _____________
Medical condition present (if any): ____________________________________
________________________________________________________________
Charm Included:
Mother Mother & Baby Sister 1 Sister 2 Nana Grandma Mimi
Aunt Niece Father Dad Brother Ribbon Feet Year
Extra Charm(s):
None Mother Mother & Baby Sister 1 Sister 2 Nana
Grandma Mimi Aunt Niece Father Dad Brother
Ribbon Feet
Add Letter/Number Charms: _______________________________________
_______________________________________________________________
All money from Boutique orders will go toward expenses for Paige's Page Outreach