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. Thanks!
Please Note: The signature and job box is not checked as required but is required. All boxes must be filled in to get monthly financing. If you are just asking a question those two boxes are not reqired to be filled in.

Your Name
City & State, Zip:
Phones: Home & or Cell: *
Job Information:
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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