CHARMELLE		ORDER FORM
	address: Charmelle, Inc., 136 Freelon Street, San Francisco, CA 94107, USA
	e-mail: orders@charmelle.com / fax: + 1 415 369 9983 / phone: +1 415 856 0000 or 1 800 846 5393 (US only)
		PLEASE FILL OUT THIS FORM COMPLETELY TO AVOID DELAYS!
	Shipping Address:
	Name:
	Street:
	Apt.#:
	City:
	State:			ZIP:
	Country:
	E-mail:
	Tel:			Fax:
	Billing Address:	CHECK HERE IS SAME AS SHIPPING:
	Name:
	Street:
	Apt.#:
	City:
	State:			ZIP:
	Country:
	E-mail:
	Tel:			Fax:
	Payment:	Credit Card:	Check:	Other:
	If paying with credit card:
	Card Type	Master card	VISA	AMEX	Discover
	Cardholder's Name:
	Exp. Date
	CVV:
	NOTE: Your card is not going to be charged until order has been proccessed and total charges confirmed by our office staff.
	Order:
Item Code (#)		Size/Type	Qty	Retail Price	Total
	Discount levels -- 60% or 80%			Discount:
				Tax (if applicable):
				Shipping:
	Shipping charges: (FedEx ExpressSaver -- $9.50; 2-Day -- $15.00; Overnight--$25.00 / International: $30.00-$40.00)
				TOTAL:
	Please note that these shipping charges apply to jewelry orders of $2000.00 in retail. Extra shipping charges apply for larger orders and orders that include sales tools and/or catalogs.
	Notes: