customer information

Customer Information Form-La Perle Melbourne

Thank you for visiting La Perle Melbourne. Please fill in your details so we can provide you with personalised service, exclusive offers, and birthday surprises! (We respect your privacy. Your information will be kept confidential and only used for store communication and special promotions.)

Name(Required)
To make your birthday extra special, we’ll send you exclusive coupons and promotions just for you!
MM slash DD slash YYYY
Jewelery Preference (Multiple Choices)(Required)
Pearl Preference (Multiple Choices)(Required)
Please let us know what's on your mind. Have a question for us? Ask away.