JEM   JEWELLERY                        ORDER   FORM

JEM JEWELLERY orders can be placed by fax on 0866 591 412, by phone on 012 253 2901 or 082 330 4936       or jem@intekom.co.za

DATE

NAME

POSTAL ADDRESS

CODE
TEL NO (OFFICE HOURS)

DIALLING CODE
CELL PHONE NO

COLLECTION   (eg. Bridal, Fashion, Tunis)	ITEM NO.	QUANTITY	DESCRIPTION & COLOUR     CHOICE	PRICE

	SUB-TOTAL (R)
	ADD POSTAGE (R)     (see rates below)
	TOTAL (R)

PLEASE  DEPOSIT  TOTAL   AMOUNT  INTO  BANKING  ACCOUNT  BEFORE  YOUR  ORDER  CAN  BE  DESPATCHED.      PLEASE  FAX  OR  CONFIRM  PAYMENT  TELEPHONICALLY  ON  012 253 2901     BANKING DETAILS    ACCOUNT  NAME:      JT LEIBENGUTH       BANK:                             STANDARD BANK     BRANCH:                       ALBERTON     BRANCH CODE:           012342     ACCOUNT NO:             404461611            LOCAL  POSTAGE  CHARGE  IS  R10.00  PER  ORDER  FOR ORDINARY  POSTAGE  AND  R35.00  FOR            OVERNIGHT  POSTAGE.     INTERNATIONAL  POSTAGE  IS  R25.00  FOR  ORDINARY  POSTAGE.              PLEASE  ENQUIRE  FOR  OTHER  RATES.