POLICE STERLING SILVER RINGS

POLICE STERLING SILVER

POLICE STERLING SILVER RING ORDER FORM

0RDER FORM

PART 1

LETTERING AROUND GEMSTONE

Your Local Law Enforcement Agency: e.g., Division/Department, Township

___________________________________________________________________________

New Cap Die Special Order: ___________________________________________________________________________

[Leave a blank for each space between words. 30 spaces/characters maximum]

One Time Service Charge For New Gemstone Cap Die

One Time Service Charge For New Insignia Cap Die

Add $100.00

Add $150.00

PART 2

BIRTH-GEM RING

CHOICE OF FACETED GEMSTONE

_______Deep Azure Blue

_______Ruby Red

Birthstone for Month of __________________

$235

NON-FACETED CABOCHON GEMSTONES

$250

PART 3

EMBLEM MOUNTED ON GEMSTONE

___Chief ___Captain ___Lieutenant ___Sergeant ___5___10___15___20 YEARS

$270

PART 4

CZ-ON-GEMSTONE

A

APACHE STAR DESIGN

CZ Set in Sterling Silver Star Mounted on Gemstone Indicated Below

$280

B

DESERT FIRE DESIGN

Choice of 3 CZ Sizes Set in Sterling Silver Mounted on Gemstone

1/10Ct.

$280

1/4 Ct.

   $290

1/3 Ct.

   $300

Indicate Gemstone Choice Below

_____Deep Azure Blue _____Ruby Red _____Black Onyx _____Birthstone for Month of_____________________

PART 5

CUBIC ZIRCONIUMS

[Without Gemstones]

ROYAL AZTEC DESIGN

Choice of 4 CZ Sizes Set in Sterling Silver

1/3 Ct. $325
1/2 Ct. $355
3/4 Ct. $375
1 Ct. $400
PART 6

INSIGNIA DESIGN

Insignia Rings are all Sterling Silver They do not have Gemstones

$199

PART 7

Please engrave initials ___________ or____________________________________ inside ring band

Up to 20 spaces/characters engraved on Gemstone rings

Only 16 spaces/characters engraved on Insignia rings

Add $20

PART 8 No C.O.D. Orders Accepted: Remittance from Canada, Mexico and other Foreign countries must be made by bank drafts or money orders payable in U.S. Currency. They are obtainable from any leading bank.

For Overseas Orders:

Add $50US

PART 9 Please Allow 4-6 Weeks For Delivery TOTAL ORDER: $

RING SIZE: _____________

Any local jeweler will check your ring size.

Name:__________________________________________________________________________________________

Address:________________________________________________________________________________________

City & State:___________________________________________________ Zip Code: _________________________

Phone:_______________________ E-Mail: ____________________________________________________________

Payment: ( ) Check or ( ) Money Order Enclosed ( ) Credit Card Info Below

( ) MasterCard or ( ) Visa: Card Number:_______________________________________________________

Expiration Date [MM/YYYY]:___________________ 3 Digit Code on Back of Card:______________________

T J JEWELRY

857 E. White Mountain Blvd. - Pinetop, AZ 85935

Phone: 1-800-544-9706 - Website: www.tjjewelry.com

Thank you for your order, we look forward to doing business with you