Kippah Order Form
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If you have trouble with this online form, contact me directly at jan@kippahdesign.com I do not sell wholesale or on consignment.

This is a custom order so please allow 7-10 days for completion.  I will e-mail you when I receive the order and confirm the wire and bead color choices before I begin.  Payment must be received before the kippah will be made.  If you need the kippah sooner, let me know and I'll do my very best to expedite your order.  Emails received on Friday evening or Saturday will be answered when Shabbat is over.  If you wish to mail payment, click here for a printable order form. I am located in North Carolina; if you are in the Midwest or West, please allow for the time difference! * Required Information * First Name * Last Name * City, State * Zip   * Phone * E-mail     Be sure to scroll down and make all your selections!  If you are ordering more than one kippah, please fill out separate order forms, but you can pay all together!   Date needed by:    Kippah Style Regular Adult $75 Bat Mitzvah ($65) Wedding Kippah $75 Center of Kippah* Plain - All Same Beads Large Coordinating Bead Sterling Magen David - $15 Gold Plated Magen David - $10 14K GF Magen David - $35 Cluster of Same Beads Other - Please specify below Wire color** Clear Silver Bright Gold Antique Gold Bright Copper Double Strand Rim Regular Rim Beaded Rim - $25 additional Fastener Clear Plastic Comb Metal Comb Hair Color (optional) No Choice Blonde Light Brown Dark Brown Auburn Red Silver Grey White Beads Please choose color family and I will select from my inventory.  Hold down CTRL key to select more than one color. 4mm Swarovski Crystal 4mm Swarovski Pearls Multi-Color Round Multi-Color Faceted Mixed Pastels Mixed Jewel Tones Black White Bright Red Garnet Red Rose Pink Light Pink Smoke Grey Yellow Orange Amber Sapphire Blue Light Blue Emerald Green Light Green Deep Purple Light Purple Gold 4mm Swarovski Bicone Crystal - $15 4mm Swarovski Pearls - $15 Please select Swarovski crystal or pearls colors from chart and specify in box below.  Colors subject to availability.   *14K gold filled Magen David must be special ordered.  Please email me about available styles. ** Double strand kippah includes the crystal.   Comments/Special Instructions:  If you have a pin or other jewel you would like incorporated into center of kippah, you can send it to me and I will do my best to fulfill your request.  If it does not have a pin back or holes for wire to pass through, then it will have to be drilled or glued, depending on the piece. List Swarovski Crystal or Pearl Colors Here:     Complete this section ONLY if you are ordering a wedding veil: Check wedding veil options here   Color Select White Off White Ivory Edge Select Plain Cut Pencil Rolled Scalloped Satin Cord Pearl 1/8 inch Ribbon 1/4 inch Ribbon 1/2 inch Ribbon 1 inch ribbon Organza Ribbon Gold/Silver Metallic Rhinestone Filigree Length Select Shoulder Elbow Fingertip Semi-Waltz Waltz Chapel Cathedral # of Tiers Select One Two Width Select 72 inches 108 inches Optional Select Scattered Pearls Scattered Crystals Additional comments or Instructions: How did you learn about Kippah Design?   Google Maven About.com Yahoo Webring Other Search Referral Choose Payment Method: Check/Money Order Payable to Jan Gorelick Mail To:  PO Box 49426, Charlotte, NC 28277 Please be sure to include a printed order form when mailing payment. I also accept credit card payments through Paypal.  If you wish to use that service, let me know and I'll send an invoice. A separate order form is required for each kippah.  If you are unsure of the total, contact me and I'll send an invoice. Please contact me by: Email Phone Submission takes just a minute or so ... please wait for confirmation. All packages are sent priority mail with delivery confirmation and insurance. Postal rates have increased; remember to add $8 shipping.