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Personal Information (*required fields)
*Last Name: *First Name: Date:
Address: City: State:
*Phone: *Email: Zip:
Item Information
Item Name: Date Needed:
Design Information
Will you provide a design?
Yes, please have a Designer contact me. I will provide a design and the requested photo reference information.
Not sure, please have a Designer contact me.
No, please have a Designer contact me regarding your design creation services. We can work together to create a design that will best reflect my unique look or style and effect that I desire.
Photo Reference

1) A picture of the design indicating the exact size, placement, colors and sizes of the stones*
2) A picture of the item indicating the exact placement of the design or designs on the item

By submitting this consultation form you agree to our policies as stated.

* We use only genuine Swarovski® rhinestones. Colors and sizes are subject to availability. See color chart, size chart and written description.
DESIGN & DEVELOPMENT BY J3 DESIGN © 2005 SPARKLESPRATZ