Order Form
HENLEY
1500 Chevron Way
Atlanta, GA   30350
Fax: 770-392-0646
Email Orders: orders@henleyjewelry.com
 Date: ____/____/20____
 
 
 

All HENLEY jewelry is handcrafted to your specifications. If you have questions about the jewelry or would like to add customized options before ordering, click on our e-mail address above and send us a message. We'll respond as soon as possible.

YOUR INFORMATION SHIP TO (IF DIFFERENT):
Name
 
 Name
Street Address
 
 Street Address
City, State/Prov   Zip/Postal   Country
 
 City, State/Prov   Zip/Postal   Country
Day Time Phone
 
 Day Time Phone
YOU MAY MAIL THIS FORM TO THE ADDRESS ABOVE OR FAX ORDERS TO 770-392-0646

 Product Code  Description   Qty     Price Each           Total        
     
     
     
     
     
     
     
     
 
We prefer the following forms of payment:
  • Personal, Business, Cashier checks
  • US Postal Service or American Express money orders

 
 SUBTOTAL  
FedEx Shipping & Handling $12.00 
GA Residents Add 7% Sales Tax  
TOTAL  

Special Notes or Instructions:
 
 
 
 
 
 

Thank You for your Order!