High Score

Premium 300 Game and
800 Series Awards
11 IN A ROW AWARD ON BACK
STEP 1: Choose Your Style
LARGE IMPERIAL (Sizes 7 – 18)
Ladies’ sovereign (Sizes 3 – 15)
SMALL IMPERIAL (Sizes 3 – 15)
300 Game
300 Game
300 Game
800 Series
800 Series
800 Series
STEP 2: Choose Your Metal
LARGE IMPERIAL
Siladium®
No Charge
Golden Siladium $50.00
10K Yellow Gold $575.00
14K Yellow Gold $800.00
SMALL IMPERIAL
Siladium®
No Charge
Golden Siladium $50.00
10K Yellow Gold $400.00
14K Yellow Gold $525.00
LADIES’ sovereign
Siladium®
No Charge
10K Yellow Gold $250.00
14K Yellow Gold $325.00
STEP 3: Choose Your Side Personalization
Two lines of text
(9 characters each)
No Personalization
No Charge
Date Bowled
Number of times
score bowled
Personalized Design
$20.00
STEP 4: Choose Your Top Options
LARGE & SMALL IMPERIAL
Signet Panel
(Standard)
No Charge
LADIES’ sovereign – Choose Your Stone
Semi-precious
Panel
$60.00
Ladies’ Sovereign
(Standard)
No Charge
Simulated Garnet
300 Game
$15.00
Gold-Inlaid
Stone
$30.00
Diamond Pavé
Panel
$120.00
Simulated Amethyst
800 Series
$15.00
After your award is certified, Keepsake will contact you directly for payment.
Please provide daytime contact information to expedite your order.
Once you receive your letter confirming your award certification, you may contact
Keepsake directly at 1-800-982-6515 to expedite your upgraded award.
keepsakebowling.com
SEE BACK SIDE FOR ORDER FORM
2010 – 2011 SEASON adult & youth application
USBC ACHIEVEMENTS Approval can be found on bowl.com
Choose Your Award (11 in a row awards below)
 300 Game  800 Series
 900 Series
Free Siladium® award rings are only provided for the first award per accomplishment for the season. You may order a ring for your accomplishment after your first free ring; however, a $40 fee wll apply.
Ring Choices
 Imperial Large (Sizes 7 – 18)  Imperial Small (Sizes 3 – 15)
 Ladies’ Sovereign (Sizes 3 – 15)
Choose Your Metal
LARGE IMPERIAL  Siladium® No Charge
 Golden Siladium $50.00
 10K Yellow Gold $575.00
 14K Yellow Gold $800.00
SMALL IMPERIAL  Siladium® No Charge
 Golden Siladium $50.00
 10K Yellow Gold $400.00
 14K Yellow Gold $525.00
 10K Yellow Gold $250.00
 14K Yellow Gold $325.00
LADIES’ SOVEREIGN  Siladium® No Charge
Choose Your Side Personalization – Imperial
 Standard – No Personalization (No Charge)
 Personalization (Add’l Charge) – Two lines of text – 9 char. each $20.00
(must have at least one line of personalization)
Line 1
Line 2
Number of Times Score Bowled: _____________
Date Bowled:
m m
–
D
D
–
Y
Y
Choose Your Top Option – Imperial
 Signet Standard (No Charge)
 Gold Inlaid Stone $30.00
 Semi Precious Panel $60.00
 Diamond Panel $120.00
Choose Your Stone – Ladies’ Sovereign
 Standard (No Charge)
 Simulated Garnet – 300 Game $15.00
 Simulated Amethyst – 800 Series $15.00
Finger Size
Order can not be processed unless all fields are complete.
11 In A Row – 300 – 800
If not selecting a ring, please select one of the following
Members are eligible for one award per accomplishment each season. If you have received an award for the same accomplishment, please choose Multiple.
11 In
A Row
Trophy


300 Game
Plaque
800 Series
 Multiple
Plaque
 No Award

OR Donate to:

Hall of Fame

Bowlers to Veterans

Earl Anthony Fund 
Susan G. Komen for the Cure
USBC HIGH SCORE APPLICATION: for 11-in-a-row, 300, 800, 900.
Center Name: _ _____________________________ Center #: _______________________________
Competition Type
(Check one)
Center Address: _ ___________________________________________________________________
Address Competition Name: _________________________ Competition #: __________________________

Competition Official: ________________________________________________________________
Print Name
Address
League
Tournament
Interscholastic

City/State/Zip

City/State/Zip
Bowler's Name: ________________________________________________________________ Bowler's ID#: ________________
Last Name
First Name
Street Address
Apt. #
M.I.
Bowler's Address: ______________________________________________________________ Date of Birth: ________________
______________________________________________________________________________ Membership:  Adult  Youth
City
State
Zip
(
)
E-mail: _____________________________________ Day Phone: _________________________
Gender:
Bowled with:
 Female
Bowler's Assn. Name: _ _________________________ Assn. Number: ___________________  Male
 Right hand
 Left hand
Date Bowled: _______________________________
_______ _______ _ ______
___________________________________________
_ _____________________ Serial Number on Ball:
MM
DD
Ball Manufacturer
Year
Game 1
Game 2
Game 3
Ball Model
X
Competition Official Signature: _________________________________________
USBC Youth members have the obligation to be aware of any restrictions that may be in
place by his/her high school athletic associations that may affect any outside competitions
they could compete in or limitations on awards that they may earn.
Bowler's Signature: __X_____________________________________________
I verify that all information relative to the high score bowled is correct.
KS200 - 0810.12720 ®2010 Commemorative Brands, Inc. All rights reser ved.
_______
Series Total
________
Average ________
No. of Games
 Yes
 No
Were all rules observed when score was bowled?
 Yes  No (if no attach explanation)
Was the game(s) pre/post bowled?
 Yes
 No
Please ship award to:
 Directly to me at the above address
 Association
 League Official
 Other: