PRODUCT ORDER FORM

Please print CLEARLY and ACCURATELY.  Please enter all information.  Use the "Option" column only if a choice is offered, but every other space must be completed in order to ensure prompt and correct delivery.  Kindly DOUBLE CHECK YOUR ORDER BEFORE MAILING.

Fine Jewelry - Many items are specially ordered, and may be shipped separately from general merchandise.  Allow up to 6-8 weeks for delivery.

Name:	_______________________________
Address 1:	_______________________________
Address 2:	_______________________________
City, State, Zip:	_______________________________
Phone:	_______________________________
Date Of Order:	_______________________________

                                                         Options:                       Total Amount
                                                         Perfume Scent,      Number     (Multiply cost per
     Item           Catalog                              Sports Team,        of Items   item by number
     Number         Item Description                     Size, or Color      Ordering   of items ordered)
 1. __________ ___________________________ _______________ _______ ___________

 2. __________ ___________________________ _______________ _______ ___________

 3. __________ ___________________________ _______________ _______ ___________

 4. __________ ___________________________ _______________ _______ ___________

 5. __________ ___________________________ _______________ _______ ___________

 6. __________ ___________________________ _______________ _______ ___________

 7. __________ ___________________________ _______________ _______ ___________

 8. __________ ___________________________ _______________ _______ ___________

                                                 MERCHANDISE TOTAL ___________

Please complete this form and mail with check or money order payable to:

Crimson Gardens
34 West Briar Drive
Stafford, Virginia  22554