Welcome to our new Order Form

Here you will input the items you wish to purchase by: Item Number, Quantity, Price, and Total Amount. All of the information is required, so you must type data in every field to accurately process your order.

Results are e-mailed to the address you type in the E-mail field, and you will be sent to a page confirming your order. Once you are re-directed to the confirmation page your order has been sent for processing, and you do not need to do anything else. Feel free to surf back to the website to continue browsing!

Fill in all of the information below and press "SUBMIT" at bottom of page.

Once submitted, the order will be e-mailed to us for processing.

Customer Information:


Customer Name: 
Address:       
City:           
State:          
Zip:           
Telephone:     
Fax:           
E-mail:

Order Form
Enter The Item Number, Quantity of each Item desired, Price for each Item, and the Amount that each Item costs.

*Item*	*Quantity*	*Price Each*	*Amount*
			$
			$
			$
			$
			$
			$
			$
			$
			$
			$

Payment Options

You can call in your order if you choose @ 607-563-9485
Pay by Credit Card (You can phone in this order!)

Card: Card Number:

Expiration Date:

We will call you to verify information.

For Credit Card Order by phone.
1-888-563-4411

Pay by Check / Money Order

If by check, please send the total amount to:

Wholesale Jewelry and Accessories
72 Main St.
Sidney, NY 13733
Phone: 1-888-563-4411
Fax: 1-607-563-9485

Payment Options

Thank You For Your Order!