Gem Stem Order Form
Please Print and Send by Mail to:
Gem Stem
PO Box 6072
Pompano Beach, FL. 33060
Phone: 954-784-0286


Send To:
Postal address:
City: State: Zip:

Phone number:

# _____Bracelets Ordered    X $39.95 + $5.50 S&H = __________
# _____Necklaces Ordered X $59.95 + $5.50 S&H = __________

TOTAL ENCLOSED:
Payment Options: Check Money Order
Please Make checks payable to: Magna Therapy Bracelet

Thank You For Your Order


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