Please provide your contact details and a Gem-Dandy Customer Service Representative will contact you shortly concerning your purchase order. If you have any questions please contact our customer service department at 800-334-5101.

Name *

First Name

Last Name

Store Name *

Customer's Account Number

Salesperson Name and Number

Contact Phone Number *

(###)

###

####

Email Address *

Bill To Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Ship To Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Purchase Order Number

Ship Date

MM

DD

YYYY

Cancel Date

MM

DD

YYYY

Optional Message:

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Thank you for your business with Gem-Dandy Accessories! One of our knowledgeable Customer Service Representatives will contact you shortly concerning your new purchase order. If you have any questions please contact our customer service department at 800-334-5101.

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