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 This form can then be completed and faxed to 508-222-3011 or mailed to 

GUYOT BROTHERS CO INC
PO Box 2378, 20 John William Street, Attleboro, MA 02703
508-222-2000

LOCKET ORDER FORM

Customer Name and Billing Address Ship to: (if different)

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( ) Subscribe to free e-letter (email address)_______________________________

Quantity

    Description

Price Each

Extension

  Vintage Rose Locket  (8251)

$ 5.00

 
  Plain Heart Locket (02247) $ 3.75  
  Vintage Floral Heart Locket (05859) $ 3.75  
  Small Round Vintage Filigree Locket (05943) $ 3.75  
 

Small Triangle Vintage Filigree Locket (04032)

$ 3.75  
 

Large Oval Vintage Locket (0681)

$ 4.25  
 

Round Vintage Locket (04391)

$ 3.75  
  Oval Vintage Locket (04392) $ 4.25  
 

minimum order 1 dozen

Total  

Lockets are shipped via U.S. Postal Service Priority Mail with Delivery Confirmation

Billing Information: ( ) Check Enclosed

Credit Card: ( ) American Express ( ) Visa ( ) MasterCard ( ) Discover

Expiration Date: __________________________Billing address_____________________________

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Signature________________________________________________________________________


ALL Guyot Brothers jewelry findings are Made in USA

(c) 2003-2009 Guyot Brothers Co Inc,
A jewelry findings manufacturer