Sourced with Love Campaign Submission Form for Customers

1. Your Name*

2. Nickname/ Preferred Name* (to be listed)

3. Country* (to be listed)

4. Your Email*

5. Mailing address to receive a gift

6-1. Name of the Brand/Designer where you or the giver purchased the diamond jewelry* (to be listed) Please note that Diamonds for Peace may contact the brand/designer.

6-2. URL of the Brand/Designer you answered in 6-1.* (to be listed)

7-1. Your diamond is* (to be listed)
The country of origin is tracedRecycled

7-2. Name of the country or mine of origin if your answer is "the country of origin is traced."

8. Your diamond is* (to be listed)
conflict free

9. On what occasion did you purchase or receive it?* (to be listed)

10. Why did the giver (the receiver) choose the particular diamond among other available diamonds?* (to be listed)

11. How did you confirm that your diamond is traceable/recycled and conflict free?* (to be listed)

12. Photos of you having a "MY DIAMOND is sourced with Love" sign board and your diamond jewelry mentioned above. (Jpg format, max 4 photos, max 2MB per photo) (to be listed)
If you haven't taken a photo yet, you can download the signs at the end of this page.

13. YouTube or Vimeo URL of your video if you'd like to share one. (to be listed)

14. Would you like to subscribe our e-newsletter?*
YesNoAlready subscribed

15. If there's anything else you'd like to add, please indicate here.