Please fill out the form below, and click the SUBMIT button at the bottom of the screen to send me your information for financing or questions or concerns. Thanks!
Please Note: Job, Residency, Bank and Social Security number information will have to be verified before I can process your order for financing. Even though the Job, Bank, Credit Union and Social Security boxes are not checked as required, they are, as well as the box for your signature if you want monthly financing. Your social security number is needed. You can text a picture of your card or any document that shows your number to 540-589-4537 or email it to . Those items are a must for financing approval. Because I don't do a credit check. that information is the way to find you should you default on my financing terms agreement.

Your Name
City & State, Zip:
Phones: Home & or Cell: *
Social Security Number.:
Job Information:
Bank or Credit Union Information:
IF you have agreed to let Michael's Jewelry finance your order. You must type your name in the box as your signed signature that says you agree to all my terms for monthly financing as shown on my/this websites Home page. :

(Fields marked with * are required)

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