Order Form                          Print Order Form

The Gem Shop, Inc.                           
W64 N723 Washington Ave                                   Phone:   262-377-4666
Cedarburg, Wisconsin  53012                                   Fax:    262-377-4804 

        The Gem Shop, Inc. order page is secured by GeoTrust. It is safe to email your credit card information. You may fill out this form and submit it, or print it out and send by fax or mail. 

Your name:
Company:
Business License/Tax #
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:
E-mail:
Comments:
Promo Code / Gift Certificate #:

 

Qty / Item#

Name

Unit Price

Total

Merchandise total
Shipping/handling charge (see below)
Subtotal
Wis. residents add 5.6% (.056) sales tax
Total

Shipping and handling charges  -- continental US only --
UPS ground service up to 70 lbs max  weight:
Please call 262.377.4666 or email for charges on larger orders 
and/or shipments to AK, HI, and international destinations.

up to 2 lbs	$  8.00
up to 5 lbs	$  9.00
up to 10 lbs	$ 12.00
up to 15 lbs	$ 14.00
up to 20 lbs	$ 16.00
each additional 5 lbs	$   4.00

 

The Gem Shop is committed to using the best shipping methods and lowest charges for our customers. Fuel surcharges have recently caused rates to increase. If it is possible to use a different shipping method with a lower charge, we will make every effort to do so.

   Credit Card options: 
Master Card, Visa, Discover, American Express
please enter card number and expiration date below:

Credit Card #		Exp.Date:
	Security Code (3 to 4 digits)
Credit Card Billing Address...   if different from above
Signature:
	To use your PayPal account, do not enter credit card number, just enter your PayPal email address and we'll send you a money request.
Email: