ORDER FORM ARTICLE
ITC 0003


Please fill out this form in all its parts.

* Obligatory fields

My address:
* First Name: * Last Name:
* Address:
* City:   * State/province:
* Zip Code: * Country:  


Contact information:
* E-mail address:
* Home Phone:
Best time to call me: my local time
Work Phone:
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Fax:

Payment by credit card:
Cards accepted:
Full name on card: Card Number :
Expiration date: Month Year

I would like to give my credit card details over the phone:

Please call me at this phone number:
Best time to call me: my local time

Please write down the charms number you would wish to order here:

Charm Number:

Quantiy:

Charm Number:

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Charm Number:

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Credit Card charging:
Your credit card will be authorized by your credit card company and then be charged for the Total Amount (article price + mailing cost) specified in this previous page according to your country area:
Area USA or Area Europe.

Order Confirmation:
Within the next 24 hours you will be receiving a Confirmation mail from Emporium Italy at your e-mail address stating: Article ordered, Article price, Mailing cost, Days delivery, Credit Card Authorization
Status, Total amount charged, day parcel will be mailed out to you.

I wish to add these articles to my order:
Art. Art. Art.

Please insert eventual information, requests or questions: