Free Gold Jewelry Submission Form


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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 request for your free gold jewelry selection. This form is to be used only when financing a gold jewelry ordered item or items as explained under Getting *Free* Gold Jewelry under our *About Us* tab.

Your Full Name, Today's Date. Your Full Address, Phone & Email & your membership #, (the last 4 numbers of your social security number).:*
Put your free gold jewelry item number in this box. Submit this form only after we, Delightful Scents have gotten your paid in full balance owed us from the jewelry item or items you financed as shown under the Getting Free Gifts (14k Gold Jewelry) Financed Orders Only, shown under our About US page.:	*

(Fields marked with * are required)