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Money Order Order Form

PRINT THIS PAGE OUT AND MAIL WITH PAYMENT **Don't click the submit form button

Name *
E-mail Address *
Phone# *
Address *
City, State, Zip Code *
Shipment Options *
Item # or Description
Item# or Description
Item# or Description
Subtotal *
Sales Tax 6.75% (no tax outside of NC)
S&H $ *
Total *
	US POSTAL MONEY ORDERS ONLY

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Make payable to: Brunson Jewelry

mail payment to: PO Box 716 Greensboro, NC 27402

All Sales Are Final. No refunds, exchanges or cancellations on jewelry, measurement kits & custom items.

**NamePlateJewelry.com does not take the molds of a customers teeth for any reason. We make your custom removable teeth jewelry exactly to the specifications of the molds mailed to us. For a professional dental teeth mold or impression, please visit your local dentist.