Custom Rhinestone Order Form
Name:
Shipping
Address
Phone
Number:
Email
Customizing Information
Another Item to Customize?
Model
Number:
Model
Number:
Color of
Item
Color of
Item
Size
Size
Rhinestone
Text/Image
Rhinestone
Text/Image
Color of
Rhinestone
Color of
Rhinestone
Detailed Description of Custom
Rhinestone Design
Where would you like the design placed?
If it is a SPECIFIC logo, do you have a web
address where we could see it?  Any additional
information for us to design it exactly as you like
Payment Information
Visa/MC/Amex
Disc/PayPal
CC Number or
PayPal Email
Address
Exp. Date
Do you want us to call to confirm this custom order? If yes,
please include best number within the hour to call
This is where YOU can custom design
your own items in RHINESTONES!

For Design Ideas...
Check out some of our Past Custom Examples
Check out our Rhinestone Stock Designs
Want to place a Phone Order Instead?
Call us at 708.932.3866
Are you ordering
MORE than 2
Custom Rhinestone
Items??

Call us to Place
Order for Special
Pricing!
708.932.3866
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