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	Instructions Please fill out the form below, and click the SUBMIT button at the bottom of the screen to send us your church, school or college information so they will get your donation percentage from your order. Your Name: * Your membership number. The last 4 numbers of your social security number: * Organization name, address, city, state, zip, phone, email and a contact name. (example: The head person of the organization).:* What kind of order did you place. Gold Financing / Cash Order or a Personalized Order. Type what you did in the space provided.: * Put the current date here.: * Comments: (Fields marked with * are required) | Return Home | Scented Items & Supplies | About Us | Liability Waiver For Scented Item Orders | Gold Jewelry | Financing, References & Employment Forms | Contact Us | Your Donation Submission Information Form | Watches |

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