Ordering Form

For those who are more comfortable with placing an order through the mail, feel free to use this handy ordering form. Just print & mail it with your money order, cashier’s check, or personal check*.

* Checks & money orders must be drawn on U.S. Bank. Please allow extra time for personal check orders. Thank You!

To print, copy & paste the order form onto a new word document, then print it out using the print button on your browser!

Crystal Emporium

P.O. Box 1535

Lomita, Ca 90717

(For faster processing, please print clearly)

Name:

Date:

Address:

City, State, Zip:

Email:

Phone:

SHIP TO (If different from above):

Address:

City, State, Zip:

Item #

Size

Color

Name (Print clearly)

Qty

Price Each

Total

1^st Class Shipping Rates

$00 - $15.00……………$ 7.00

$16 - $25.00……………$ 7.25

$26 - $35.00……………$ 7.50

$36 - $50.00……………$ 7.75

$51 - $75.00……………$ 8.00

$76 - $99.00……………$ 9.00

Over $100.00…….........$10.00

Lifetime Supply of Enjoyment: FREE!!!

Subtotal:

Shipping & Handling (See chart on left):

Insurance: Below $50 (Optional $2.00);

$51-100 (Add $3.00):

Ca residents: Please add 8.25% sales tax:

Total:

Affordable prices & excellent service for yourself & the ones you love.