Originalz Creative Custom Jewelry

You may place a custom order online using this form or you may print and fax or mail the PDF order form.

Payment in the form of cashiers check or money order should be mailed to: Originalz creative custom jewelry, 7030 Church Wood Lane, Huntersville, NC 28078. Please contact us via email at info@originalzbyjohnna.com if you have any questions.

Namesake/Mommy Bracelet

Adult: $85/bracelet plus $5 per letter (example AMY: $85 + $15 =$100)
Youth: $55/bracelet (no additional charge for letters)

Name 1:

Name 2:

Name 3:

Use the space below to share with me what you would like to see in your bracelet. For example: small, medium or large beads, favorite colors, style of bracelet, conservative or chunky.

How would you characterize yourself or person for whom the jewelry is being created for? (personality, individual qualities, traits) Please indicate any hobbies, personal interests, recent experiences (marriage, birth of a child, new job, new home, celebration, etc.) to help capture the essence of the wearer of this special custom piece.

Size: Other size (please specify):

Please calculate the price of your bracelet and enter here:

US Postal Service Priority Mail:
includes delivery confirmation and insurance $6.95

Enter the total here:

Please indicate the form of payment you will be using for this purchase:
Major Credit Card via Paypal
Cashiers Check or Money Order

Name required:

Email required:

Address (street, city, state, zip) required:

Phone required:

If you would like your order to be shipped to a different address, please list the shipping address below.

Recipient Name:

Shipping Address (street, city, state, zip):

Recipient Phone:

Payment is required at time of order. You can mail your payment (cashier's check or money order) to Originalz creative custom jewelry, 7030 Church Wood Lane, Huntersville, NC 28078.

Please review the information you have entered above. If everything is correct, please press the "submit" button below.