ADULT LIFETIME 300 GAME AND 800 SERIES AWARDS

STEP 1: Choose Your Ring Style
ADULT LIFETIME 300 GAME AND
800 SERIES AWARDS
MEN’S PRESTIGE (Sizes 7 – 18)
300 GAME
LADIES’ PRESTIGE (Sizes 3 – 15)
800 SERIES
300 GAME
LADIES’ PREMIER (Sizes 3 – 15)
800 SERIES
300 GAME
800 SERIES
STEP 2: Choose Your Metal
MEN’S PRESTIGE
Siladium®
Golden Siladium
Siladium Two-Tone
10K Yellow Gold
14K Yellow Gold
No Charge
$50.00
$200.00
$625.00
$875.00
Siladium Two-Tone
Prestige
LADIES’ PRESTIGE
Siladium
Golden Siladium
Siladium Two-Tone
10K Yellow Gold
14K Yellow Gold
LADIES’ PREMIER
No Charge Siladium
$50.00
10K Yellow Gold
$160.00
14K Yellow Gold
$425.00
$525.00
No Charge
$315.00
$400.00
STEP 3: Choose Your Side Personalization
No Personalization
Two lines of text
(9 characters per line)
Date Bowled
LADIES’ PREMIER
Diamond Accent Stones
$60.00
Number of times
score bowled
(Standard)
No Charge
Personalized Design
$25.00
STEP 4: Choose Your Top Options
PRESTIGE TOP PIN OPTIONS
PRESTIGE PANEL/STONE OPTIONS
300 Game
Classic Pin
800 Series
LADIES’ PREMIER – Choose Your Stone
Ladies’ Premier
Signet Panel
(Standard)
(Standard)
(Standard)
No Charge
No Charge
No Charge
Lab-created Ruby
300 Game
$25.00
CZ Zenith-Set
Stone
$50.00
Personalized Pin
(3 characters)
$10.00
Genuine Amethyst
800 Series
$25.00
10K Yellow
Gold Panel
$75.00
DiamondAccent Pin
$60.00
Diamond
Zenith-Set Stone
$150.00
Once your score has been certified, call Keepsake at 800-982-6515 to place your upgrade order.
CRYSTAL 300 Game
AWARDS Crystal Award
AND
PLAQUES
800 Series
Crystal Award
Call USBC at 800-514-2695 to place your Crystal Awards and Plaques order.
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.
2016-2017 ADULT HIGH SCORE APPLICATION: 300 Game and 800 Series.
ORDER CANNOT BE PROCESSED UNLESS ALL FIELDS ARE COMPLETE.
Competition Type
Center Name: _______________________________ Center #: _______________________________




Center Address: _____________________________________________________________________
Address City/State/Zip
Competition Name: _________________________ Competition #: __________________________
Competition Official: _________________________________________________________________
Print Name
Address
(Check one)
League
Tournament
Interscholastic
Modified Format
(scoresheet attached)
Note: See USBC Playing Rule 3 for
modified competition formats.
City/State/Zip
Bowler's Name: _________________________________________________________________________ Bowler's ID#: _____________
Last Name
First Name
M.I.
Bowler's Address: _______________________________________________________________________ Date of Birth: _____________
Street Address
Apt. #
_______________________________________________________________________________________ Gender:
Bowled with:
 Female
(
)
E-mail: _____________________________________ Day Phone: _________________________________
 Male
City
 Right hand
 Left hand
StateZip
Bowler's Assn. Name: ___________________________ Assn. Number: ___________________________
Date Bowled: _______________________________
_______ _______ _______
___________________________________________
______________________ Serial Number on Ball:
MMDD
Year
Ball Manufacturer
Game 1
Game 2
Game 3
Ball Model
Competition Official Signature: __X________________________________________
_______
Series Total
________
Average ________
No. of Games
 Yes
 No
Were all rules observed when score was bowled?
 Yes  No, (if no attach explanation)
Was/were the game(s) pre/post bowled?
 Yes
 No
USBC LIFETIME ADULT ACHIEVEMENTS Approval can be found on bowl.com
Choose Your Award
Please note if this
achievement is:
 300 Game  800 Series  Multiple achievements. (additional fees will apply)
Do NOT select an award on this form. Please see NOTE* below.
 First adult lifetime achievement for this score.
Please select award below.  Men’s Prestige Ring
Finger Size ___.___ (sizes 7-18)
 Ladies’ Prestige Ring
Finger Size ___.___ (sizes 3-15)
Crystal Awards/Plaques:
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
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
 800 Series Crystal Award
Prestige Side Personalization (Choose one)
 Standard Side No Charge
 Custom Side $25.00
Text Line 1:
(up to 9 characters
in ALL CAPS)
Text Line 2:
(up to 9 characters
in ALL CAPS)
Date Bowled: M
M
-
D
D
-
Y
 300 Game Plaque
 800 Series Plaque
Donation Options:
 Hall of Fame
 Earl Anthony Fund
 Bowlers to Veterans Link (BVL)
 Susan G. Komen for the Cure
 Youth Education Services
(YES Fund)
 Ladies’ Premier Ring
Finger Size ___.___ (sizes 3-15)
Metal Choice (Choose one)
 Siladium  10K Yellow Gold
 14K Yellow Gold
No Charge
$315.00
$400.00
Premier Side Personalization
Y
(Choose one)
 CZ Accents  Diamond Accents # of Times Score Bowled: ______
Prestige Panel/Stone Choice
(Choose one)
Prestige Top Pin Choice
(Choose one)
 Signet Panel No Charge
 Classic Pin No Charge
 CZ Zenith Stone $50.00
 Personalized Pin $10.00
 10K Yellow Panel $75.00
 Diamond Zenith Stone $150.00
 300 Game Crystal Award
No Charge
$60.00
Premier Center Stone Choice
(Choose one)
(up to 3 characters
in ALL CAPS)
 Diamond Accent Pin $60.00
 CZ (Standard)  Lab-created Ruby (300 Game)
 Genuine Amethyst (800 Series)
No Charge
$25.00
$25.00
 No award requested for this achievement.
Please ship award to:
 Directly to me at the above address
X
 Association
Bowler's Signature:_____________________________________________________
I verify that all information relative to the high score bowled is correct.
 League Official
*NOTE: Once your achievement is certified, additional awards may be
purchased at Keepsakebowling.com or at USBCBowlingAwards.com
KS204-0816.25270
 Other: