CC Type:
Exp Date:
Payment Notes:
June 2016 Order Form Page 1 of 3
NEW CUSTOMER
REORDER
PO #:
Sales Rep:
Show:
Order Date:
Ship Date:
Bill to Customer:
Card #
CVV:
File CC:
YES
Store Contact/Buyer:
Customer ID:
Ship To Address:
Store Phone #:
City:
State:
Zip:
State:
Zip:
Buyer Phone #:
Billing Address:
Buyer Email:
City:
Billing Contact:
Resale License # CA Accounts Only:
Terms:
Billing Email:
Display Unit
Store Type (Must Choose One)
A-Café
B-Boutique
E-School Store
F-Florist
H-Home Int/Gift
J-Jewelry Store
M-Hospital Gift Store
N-Non Profit Found.
C-Church Store
G-Gift Store
K-Bookstore
P-Pharmacy
R-Religious Store
S-Spa/Salon
W-Online Store
X-Catalogue
U-Undetermined
Wood Display
01 West Region- CA, WA, OR, MT, ID, WY, UT, CO, NM, AZ, NV, HI, AK
02 Midwest Region-ND, MN, WI, IA, SD, NE, MO, KS
Item ID
Qty
Display Inserts
Insert Type
Item ID
Triptych Display Insert Disp Insert Triptych
White Blessings Stack Disp Insert BlesWhit
03 South Region- TX, OK, AR, LA, MS, TN, AL, GA, SC, NC, FL
04 Northest Region- IL, KY, MI, IN, OH, WV, VA, PA, NY, MA, RI, CT, NJ, DE, MD, NH, VT, ME
Qty
SUBTOTAL
PRICE
SUBTOTAL
$20.00
$10.00
TOTAL:
Notes:
BLESSING BRACELETS
SERENITY BRACELETS
Quantity
BBS Silver
Quantity
BBG Gold
BBM Mix
Black-101
Brown-102
Tan-103
White-104
Slate-105
Red-106
Navy-107
Turq-109
Orange-110
Pink-111
Purple-112
Merlot-113
Green-117
Olive-121
Persimmon-123
Eggplant-124
Fuchsia-130
MT Gold-114
MT Silver-115
Price SubTotal
$28.00
$0.00 Black-101
$28.00
$0.00 White-104
$28.00
$0.00 Slate-105
$28.00
$0.00 Red-106
$28.00
$0.00 Navy-107
$28.00
$0.00 Orange-110
$28.00
$0.00 Merlot-113
$28.00
$0.00 Eggplant-124
$28.00
$0.00 MT Gold-114
$28.00
$0.00 MTS Gold-114
$28.00
$0.00 MT Silver-115
$28.00
$0.00
$28.00
$0.00
$28.00
$0.00
$28.00
$0.00 Black-101
$28.00
$0.00 Red-106
$28.00
$0.00 Blue-116
$28.00
$0.00 Mint-129
$28.00
$0.00 Fuchsia-130
B-SER-S Silver
B-SER-G Gold
B-PR Silver
B-PRG Gold
TOTAL
$0.00
Price
$21.00
SubTotal
$0.00
$0.00
$0.00
BRMT Gold-114
$0.00
BRMT Silver-115
$0.00
BRMT Copper-119
$0.00
$0.00
$0.00
MIRACULOUS MARY BRACELETS
TOTAL
DIVINE BLESSING BRACELETS
Qty
LINK BRACELETS
Qty
Price
Price
SubTotal
Divine Platinum (BPBP)
Tan/Silver S-103
Slate/Silver S-105
$49.75
$49.75
$0.00 G-Gold
$0.00 S-Silver
M-Mixed
$0.00
$0.00
Divine Rose Gold (BPBR)
S-131 Cream/Silver
G-131 Cream/Gold
$58.75
$58.75
$58.75
SOAR BRACELETS
$0.00 Black-101
$0.00 Navy-107
$0.00 Lte Blue-108
Divine Gold (BPBG)
$49.75
$49.75
$49.75
$49.75
$38.75
$38.75
$38.75
$38.75
$38.75
$0.00
$0.00
$0.00
$0.00
$0.00
$69.00
$69.00
$69.00
$69.00
$69.00
$0.00
$0.00
$0.00
$0.00
$0.00
$28.00
$28.00
$28.00
$28.00
Qty
Black-101
$0.00 White-104
$0.00 Slate-105
$0.00 Turq-109
Price SubTotal
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
$12.00
$0.00
Price SubTotal
$28.00
$0.00
$28.00
$0.00
$28.00
$0.00
$28.00
$0.00
KIDS BLESSING BRACELETS (KBB)
$0.00
Miraculous Mary-Mixed (MMBB-M)
$0.00 Black-101
$28.00
$0.00
MOTHERLY LOVE (BML-AS)
$0.00
$0.00
Black-101
$45.00
$0.00
$0.00 Slate-105
$45.00
$0.00
$0.00 Eggplant-124
$45.00
$0.00
DIVINE MERCY (DMS)
$0.00
Black-101
White-104
Red-106
Navy-107
Pink-111
Purple-112
Rainbow-118
$21.00
$21.00
$21.00
$21.00
$21.00
$21.00
$21.00
MEN'S COLLECTION
Blessings for Him (MBBS)
Black-101
$28.00
$0.00
Navy-107
$28.00
$0.00 Black-101
$28.00
Faith for Him (MFBB)
Merlot-113
$28.00
$0.00
GARMENT OF GRACE (BGG)
Black-101
$28.00
Brilliance Bracelet (B-BRI)
Black/Silver S-101
Black/Gold G-101
Slate/Silver S-105
Cream/Silver S-131
Cream/Gold G-131
$0.00
TOTAL
$0.00
BLESSING IN FAITH BRACELETS (BBFM)
Price SubTotal
Miraculous Mary-Gold (MMBBG)
Navy-107
$0.00 Black-101
$33.75
$0.00 Tan-103
$33.75
Eggplant-124
$33.75
Soar Gold (BSW-G)
$0.00
$0.00 Black-101
$33.75
$0.00 Tan-103
$33.75
$0.00 Eggplant-124
$33.75
B-BRG Gold
Black-101
Red-106
Navy-107
Turq-109
Orange-110
Pink-111
Purple-112
Merlot-113
Blue-116
Green-117
Rainbow-118
Olive-121
Taupe-122
Yellow-125
Mint-129
Fuchsia-130
Qty
Soar Silver (BSW-S)
$49.75
$49.75
BRILLIANCE COLLECTION
B-BR Silver
Miraculous Mary-Silver (MMBB)
$49.75
$49.75
$0.00
$0.00
SubTotal
Blessed Links Toggle Bracelet (BLTB)
Ivory (BPB)
Black/Silver S-101
Black/Gold G-101
Quantity
SubTotal
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PRAYER PARTNER
$0.00
BREATHE BRACELETS
Price
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
$16.75
MT Gold-114
MT Silver-115
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Men's ONE Blessing (MOBB)
S Black-101
$34.00
S Tan-103
$34.00
FAITH BRACELETS
Brilliance Trinity Bracelet (B-BRT)
Black/Silver S-101
Black/Gold G-101
Slate/Silver S-105
Cream/Silver S-131
Cream/Gold G-131
PRICE
$15.00
Wood Display
Z-Other
Region (Must Choose One)
G-101 Black/Gold
G-104 White/Gold
G-107 Navy/Gold
G-126 Denim/Gold
NO
$0.00 Black-101
$0.00 Brown-102
Tan-103
Slate-105
$28.00
$28.00
$28.00
$28.00
$0.00
$0.00
$0.00
$0.00
Silver (FBB)
Black-101
Tan-103
Slate-105
Turq-109
Merlot-113
$28.00
$28.00
$28.00
$28.00
$28.00
$0.00
$0.00
$0.00
$0.00
$0.00
Mixed (FBBM)
Black-101
Tan-103
TOTAL
$0.00
TOTAL
$0.00
$28.00
$28.00
TOTAL
$0.00
$0.00
$0.00
PAGE ONE TOTAL:
2515 S. WESTERN AVE., SUITE 210B SAN PEDRO, CA 90732 PHONE: 424.772.1100 FAX: 424.772.1397 WEBSITE: WWW.MYSAINTMYHERO.COM
TOTAL
$0.00
$0.00
SPECIALTIES, NECKLACES, EARRINGS, ROSARIES, SACRAMENTALS
CC Type:
June 2016 Order Form Page 2 of 3
NEW CUSTOMER
REORDER
Order Date:
1/0/1900
Ship Date:
1/0/1900
PO #:
0
Sales Rep:
0
Show:
Bill to Customer:
Customer ID:
Ship To Address:
0
0
0
State:
0
Billing Address:
Zip:
0
0
City:
0
State:
0-Jan
0
CVV:
0
File CC:
YES
NO
0
0
City:
0 Card #
Exp Date:
Payment Notes:
0
Resale License # CA Accounts Only:
Store Contact/Buyer:
0
Store Phone #:
0
Buyer Phone #:
0
Buyer Email:
Zip:
0
0
Billing Contact:
0
0
Terms:
0
Billing Email:
0
Display Unit
Store Type (Must Choose One)
A-Café
E-School Store
H-Home Int/Gift
M-Hospital Gift Store
R-Religious Store
W-Online Store
B-Boutique
F-Florist
J-Jewelry Store
N-Non Profit Found.
S-Spa/Salon
X-Catalogue
C-Church Store
G-Gift Store
K-Bookstore
P-Pharmacy
U-Undetermined
Z-Other
Item ID
Region (Must Choose One)
Wood Display
Wood Display
Insert Type
Item ID
Qty
$15.00
03 South Region- TX, OK, AR, LA, MS, TN, AL, GA, SC, NC, FL
02 Midwest Region-ND, MN, WI, IA, SD, NE, MO, KS
04 Northest Region- IL, KY, MI, IN, OH, WV, VA, PA, NY, MA, RI, CT, NJ, DE, MD, NH, VT, ME
Qty
PRICE
$20.00
$10.00
TOTAL:
Notes:
PETITE NECKLACES
Qty
Price SubTotal
SPECIALTY NECKLACES
Qty
Price SubTotal
Benedictine Beadball
NBBS-20
$25.00
$0.00
$80.00
$80.00
NLB-G-20
NLB-S-20
$40.00
$40.00
$0.00
$0.00
Faith Petite Necklace
$95.00
$95.00
NBY-G-Gold
NBY-S-Silver
$0.00 EBS-G-Gold
$0.00 EBS-S-Silver
Silver Chain (NPT-S)
Clear Crystal-CC
Blue Crystal-BL
$28.75
$28.75
$45.00
NSS-Silver
$98.75
NGG-AS-Silver
Gold Chain (NPT-G)
$28.75
$0.00
$28.75
$0.00
TOTAL
$0.00
COMMUNION/CONFIRMATION
Qty
Price SubTotal
Black Crystal-BK
Queen of the Universe
$21.00
$21.00
$0.00 EFS-G-Gold
$0.00 EFS-S-Silver
$0.00
$0.00
$0.00
$21.00
$21.00
$0.00
$0.00
Benedictine Gold Rim
$0.00 EBGRM
$25.00
Garment of Grace Necklace
$0.00
$0.00
$0.00
$0.00
Faith Stud
Scapular Necklace
NPG-85
$40.00
$0.00
NPS-85
$40.00
$0.00
TRINITY PETITE NECKLACES
SUBTOTAL
Benedictine Stud
Brilliance by the Yard
NPG-20
NPS-20
$0.00
EARRING COLLECTION
Qty
Price SubTotal
Blessings by the Yard
Benedictine Petite Necklace
SUBTOTAL
Display Inserts
Triptych Display Insert Disp Insert Triptych
White Blessings Stack Disp Insert BlesWhit
01 West Region- CA, WA, OR, MT, ID, WY, UT, CO, NM, AZ, NV, HI, AK
PRICE
$0.00
Joy Earring
$0.00 EJG-Gold
EJS-Silver
$23.00
$23.00
$0.00
$0.00
Scapular Earrings
$172.00
$172.00
NQU-G-Gold
NQU-S-Silver
$0.00
$0.00 ESS-Silver
$21.00
$0.00
TOTAL
$0.00
Rose Quartz-RQ
TOTAL
$0.00
POPE FRANCIS COLLECTION
Qty
Price SubTotal
In Communion Sets
Set-1C
Set-1CB (Boys)
$42.00
$42.00
Silver Serenity (B-SER-S-23)
$0.00
$0.00
Black-101
$16.75
FOREVER ONE
Qty
Price SubTotal
Mr and Mrs (B-FO-SET)
$0.00 Black-101
Silver Breathe (B-BR-23)
$30.50
Wedding Guest (B-FOG)
1st Communion Blessing for Kids (KBB-1C)
Black-101
Black-101
White-104
Navy-107
$21.00
$21.00
$21.00
$0.00
$0.00
$0.00
Confirmation Blessing Bracelet (BB-CF)
S Black-101
$28.00
$0.00
S Tan-103
$28.00
$0.00
G Red-106
$28.00
$0.00
PRAYER PLEDGE BOOKLETS
Prayer Booklet
Med Rosary Booklet
$7.00
$7.00
$12.00
$0.00 S Black-101
Men's ONE Blessing (MOBB-23)
MT Gold-114
MT Silver-115
Black-101
$28.00
$16.75
$16.75
$16.75
$0.00 Red-106
$30.00
$0.00
Navy-107
$30.00
$0.00
BLESSINGS FOR A CURE (BB-C)
$0.00
$0.00 Pink-111
$30.00
$0.00
BLESSINGS FOR LOVE (BB-L)
$0.00
$0.00
Love & Mercy Bracelet Set (B-LM)
Black/Black-0101
Silver/Navy-1507
$42.00
$42.00
SPECIALTY BRACELETS
Qty
Price SubTotal
BLESSINGS FOR AMERICA (BB-A)
White-104
Red-106
Pink-111
$0.00
$0.00
$30.00
$30.00
$30.00
ONE LIFE LA
B-PR-1LA
$11.00
BLESSINGS OF JOY (BBJ)
$0.00
$0.00
Gold G-MT-114
Silver S-MT-115
TOTAL
$0.00
TOTAL
$0.00
TOTAL
$0.00
PAGE TWO TOTAL:
2515 S. WESTERN AVE., SUITE 210B SAN PEDRO, CA 90732 PHONE: 424.772.1100 FAX: 424.772.1397 WEBSITE: WWW.MYSAINTMYHERO.COM
$28.00
$28.00
TOTAL
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PRE ORDER FORM: ITEMS WITH FUTURE SHIP DATE
CC Type:
June 2016 Order Form Page 3 of 3
NEW CUSTOMER
REORDER
Order Date:
1/0/1900
Ship Date:
1/0/1900
PO #:
0
Sales Rep:
0
Show:
Bill to Customer:
Customer ID:
Ship To Address:
0
0
0
State:
0
Billing Address:
Zip:
0
0
City:
0
State:
0-Jan
0
CVV:
0
File CC:
YES
NO
0
0
City:
0 Card #
Exp Date:
Payment Notes:
0
Resale License # CA Accounts Only:
Store Contact/Buyer:
0
Store Phone #:
0
Buyer Phone #:
0
Buyer Email:
Zip:
0
0
Billing Contact:
0
0
Terms:
0
Billing Email:
0
Display Unit
Store Type (Must Choose One)
A-Café
E-School Store
H-Home Int/Gift
M-Hospital Gift Store
R-Religious Store
W-Online Store
B-Boutique
F-Florist
J-Jewelry Store
N-Non Profit Found.
S-Spa/Salon
X-Catalogue
C-Church Store
G-Gift Store
K-Bookstore
P-Pharmacy
U-Undetermined
Z-Other
Item ID
Region (Must Choose One)
Wood Display
Wood Display
Insert Type
Item ID
03 South Region- TX, OK, AR, LA, MS, TN, AL, GA, SC, NC, FL
02 Midwest Region-ND, MN, WI, IA, SD, NE, MO, KS
04 Northest Region- IL, KY, MI, IN, OH, WV, VA, PA, NY, MA, RI, CT, NJ, DE, MD, NH, VT, ME
PRICE
Qty
PRICE
Qty
Price
NECKLACES
SubTotal
Qty
$49.75
$0.00
DEUT. 6:5 BANGLE
SUBTOTAL
$0.00
$0.00
$0.00
EARRINGS
SubTotal
Qty
HOLY SPIRIT NECKLACE
Benedictine Link Bracelet (BBL)
AS-Atq Silver
Price
$0.00
$20.00
$10.00
TOTAL:
Notes:
BRACELETS
SUBTOTAL
$15.00
Display Inserts
Triptych Display Insert Disp Insert Triptych
White Blessings Stack Disp Insert BlesWhit
01 West Region- CA, WA, OR, MT, ID, WY, UT, CO, NM, AZ, NV, HI, AK
Qty
Price SubTotal
Brilliance Drop
NHS-G-Gold
$33.75
$0.00 EBRI-G-Gold
$33.50
$0.00
NHS-S-Silver
$33.75
$0.00 EBRI-S-Silver
$33.50
$0.00
Brilliance Crystal Necklace (NBRIC)
Brilliance Faith
Small (BGL)
G-Gold SM
$49.75
$0.00
G-Gold
$35.75
$0.00 EBRIF-G-Gold
$29.50
$0.00
S-Silver SM
$49.75
$0.00
S-Silver
$35.75
$0.00 EBRIF-S-Silver
$29.50
$0.00
TOTAL
$0.00
Average (BGL)
G-Gold AVG
$49.75
$0.00
S-Silver AVG
$49.75
$0.00
BREATHE CHAIN BRACELET (B-BRC)
G-Gold
S-Silver
$29.50
$29.50
TOTAL
$0.00
$0.00
$0.00
TOTAL
$0.00
PAGE THREE TOTAL:
GRAND TOTAL:
$0.00
*Shipping and Handling is determined at time of invoice
2515 S. WESTERN AVE., SUITE 210B SAN PEDRO, CA 90732 PHONE: 424.772.1100 FAX: 424.772.1397 WEBSITE: WWW.MYSAINTMYHERO.COM
$0.00