| To: | Jewelry Trends | Fax Number: | 1-866-320-4567 |
| Subject | Credit card details from for their order from Jewelry Trends |
| Please print this form from your browser, complete your credit card details in section 2 and sign and date in section 3 before faxing to us: |
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| Section 1 - Your details: |
| Name: | |
| Address: |
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| Tel: | |
| Email: | |
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| Section 2 - Credit Card details: |
| Description: |
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| Currency: | |
| Amount: | |
| Cardholders name (as it appears on card): | |
| Credit card number: | |
| Start date - if available: (mm/yy) | / | Expiry date: (mm/yy) | / |
| Security code: (3 digits) | | Issue number - Switch only: | |
| If you have any questions regarding the processing or storage of your credit card details please read our privacy policy or feel free to contact us. |
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| Section 3 - Signature: |
| Cardholders signature: |
| Date: | |
| PLEASE NOTE: Your order will not be processed or shipped until we have received your credit card details. |
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| Thank you for making your purchase from Jewelry Trends. |
Jewelry Trends
950 79th Terrace #2
Miami Beach, Florida, 33141
United States
US: 1-800-495-3081
Int.:1-(305)-409-1342
Nederland: 010-8923708 |
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