MEN’S PRESTIGE

Siladium® No Charge Golden Siladium $50.00 Siladium Two-Tone $200.00 10K Yellow Gold $625.00 14K Yellow Gold $875.00

LADIES’ PRESTIGE Siladium No Charge Golden Siladium $50.00 Siladium Two-Tone $160.00 10K Yellow Gold $425.00 14K Yellow Gold $525.00

LADIES’ PREMIER Siladium No Charge 10K Yellow Gold $315.00 14K Yellow Gold $400.00

Date BowledTwo lines of text (9 characters per line)

Number of timesscore bowled

STEP 1: Choose Your Ring Style

STEP 2: Choose Your Metal

STEP 3: Choose Your Side Personalization

STEP 4: Choose Your Top Options

PRESTIGE PANEL/STONE OPTIONSPRESTIGE TOP PIN OPTIONS LADIES’ PREMIER – Choose Your Stone

ADULT LIFETIME 300 GAME AND800 SERIES AWARDS

MEN’S PRESTIGE (Sizes 7 – 18)

300 GAME 800 SERIES

No Personalization(Standard) No Charge

Personalized Design $25.00

Lab-created Ruby 300 Game$25.00

Cubic Zirconia (Standard)No Charge

Genuine Amethyst 800 Series$25.00

Personalized Pin (3 characters)$10.00

Signet Panel(Standard)No Charge

Classic Pin(Standard)No Charge

300 Game 800 Series

10K Yellow Gold Panel

$75.00

Diamond Zenith-Set Stone

$150.00

Diamond- Accent Pin$60.00

CZ Zenith-Set Stone

$50.00

300 GAME 800 SERIES

LADIES’ PRESTIGE (Sizes 3 – 15)

300 GAME 800 SERIES

LADIES’ PREMIER (Sizes 3 – 15)

LADIES’ PREMIER Diamond Accent Stones $60.00

Siladium Two-Tone Prestige

800 Series Crystal Award

300 Game Plaque

800 Series Plaque

CRYSTAL AWARDSANDPLAQUES

Once your score has been certified, call Keepsake at 800-982-6515 to expedite your upgrade order.

300 Game Crystal Award

I verify that all information relative to the high score bowled is correct.Bowler's Signature: ____________________________________________________

Please ship award to: Directly to me at the above address Association League Official

Other:

X

2014-2015 ADULT HIGH SCORE APPLICATION: 300 Game and 800 Series.

Center Name: ______________________________ Center #: ______________________________

Center Address: ____________________________________________________________________

Competition Name: ________________________ Competition #: _________________________

Competition Official: ________________________________________________________________

Bowler's Name: ________________________________________________________________________ Bowler's ID#: ____________

Bowler's Address: ______________________________________________________________________ Date of Birth: ____________

_______________________________________________________________________________________

E-mail: ____________________________________ Day Phone: ________________________________

Bowler's Assn. Name: __________________________ Assn. Number: __________________________

Address City/State/Zip

Last Name First Name M.I.

City State Zip

Street Address Apt. #

Print Name Address City/State/Zip

Gender: Female Male

Bowled with: Right hand Left hand( )

Were all rules observed when score was bowled? Yes No (if no attach explanation)Was/were the game(s) pre/post bowled? Yes No

MM DD Year

Ball Manufacturer Ball Model

Game 1 Game 2 Game 3 Series Total Average No. of GamesDate Bowled: ______________________________ ______ ______ ______ ______ _______ _______

___________________________________________ _____________________ Serial Number on Ball: Yes No

Competition Official Signature: _________________________________________X

USBC LIFETIME ACHIEVEMENTS Approval can be found on bowl.com

ORDER CANNOT BE PROCESSED UNLESS ALL FIELDS ARE COMPLETE.

*NOTE: Once your achievement is approved, additional awards may be purchased at Keepsakebowling.com or at USBCBowlingAwards.com

300 Game 800 Series

Finger Size ___.___ (sizes 7-18)

Men’s Metal Choice (Choose one) Siladium No Charge Golden Siladium $50.00 Siladium Two-Tone $200.00 10K Yellow Gold $625.00 14K Yellow Gold $875.00

Standard Side No Charge Custom Side $25.00

Signet Panel No Charge

CZ Zenith Stone $50.00

10K Yellow Panel $75.00

Diamond Zenith Stone $150.00

Classic Pin No Charge

Personalized Pin $10.00

Diamond Accent Pin $60.00

Finger Size ___.___ (sizes 3-15)

Ladies’ Metal Choice (Choose one) Siladium No Charge Golden Siladium $50.00 Siladium Two-Tone $160.00 10K Yellow Gold $425.00 14K Yellow Gold $525.00

First lifetime achievement for this score. Please select award below.

Choose Your Award

Men’s Prestige Ring

Prestige Side Personalization (Choose one)

Prestige Panel/Stone Choice (Choose one)

No award requested for this achievement.

Prestige Top Pin Choice (Choose one)

Ladies’ Prestige Ring

Finger Size ___.___ (sizes 3-15)

Metal Choice (Choose one) Siladium No Charge 10K Yellow Gold $315.00 14K Yellow Gold $400.00

Premier Side Personalization (Choose one) CZ Accents No Charge Diamond Accents $60.00

Premier Center Stone Choice (Choose one) CZ (Standard) No Charge Lab-created Ruby (300 Game) $25.00 Genuine Amethyst (800 Series) $25.00

Ladies’ Premier Ring

Please note if this achievement is:

League Tournament Interscholastic Modified Format (scoresheet attached)Note: See USBC Playing Rule 3 for modified competition formats.

(Check one) Competition Type

Text Line 1:

Text Line 2:

Date Bowled: - -# of Times Score Bowled: ______

M M D D Y Y

Donation Options: Hall of Fame Earl Anthony Fund Bowlers to Veterans Link (BVL) Susan G. Komen for the Cure Youth Education Services (YES Fund)

Crystal Awards/Plaques:

300 Game Crystal Award

800 Series Crystal Award

300 Game Plaque

800 Series Plaque

Notify league processor within 48 hours of 300 game or 800 series. Application must be submitted to league processor within 20 days of score.

Multiple achievements. Do NOT select an award on this form. Please see NOTE* below.

(up to 3 characters in ALL CAPS)

(up to 9 characters in ALL CAPS)

(up to 9 characters in ALL CAPS)