POLICE GOLD ORDER FORM
| PART 1 |
LETTERING AROUND GEMSTONE |
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Your Local Law Enforcement Agency: e.g., Division/Department, Township ___________________________________________________________________________ New Cap Die Special Order Lettering: ___________________________________________________________________________ [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 |
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| PART 2 |
10K YELLOW GOLD BIRTH-GEM RING CHOICE OF FACETED GEMSTONE |
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_______Deep Azure Blue |
_______Ruby Red |
Birthstone for Month of __________________ |
$585 |
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NON-FACETED CABOCHON GEMSTONE |
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| _______Black Onyx | _______Jade | _______Cat’s Eye |
$600 |
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| PART 3 |
EMBLEM MOUNTED ON GEMSTONE |
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| ___Chief ___Captain ___Lieutenant ___Sergeant ___5___10___15___20 YEARS |
$600 |
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| PART 4 |
DIAMOND-ON-GEMSTONE |
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APACHE STAR DESIGN Diamond Set in Gold Star Mounted on Gemstone Indicated Below |
$635 |
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DESERT FIRE DESIGN Choice of 3 Diamond Sizes Set in Gold Mounted on Gemstone |
1/10 Ct. |
$825 |
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| 1/4 Ct. |
$1195 |
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| 1/3 Ct. |
$1470 |
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Indicate Gemstone Choice Below _____Deep Azure Blue _____Ruby Red _____Black Onyx _____ Birthstone for Month of_____________________ |
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| PART 5 |
DIAMOND SET IN WHITE GOLD [Without Gemstones] |
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ROYAL AZTEC DESIGN Choice of 4 Diamond Sizes Set in Gold Mounting |
1/3 Ct. |
$1575 |
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1/2 Ct. |
CALL |
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3/4 Ct. |
CALL |
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1 Ct. |
CALL |
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| PART 6 |
INSIGNIA DESIGN IN 10K YELLOW GOLD |
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Insignia Rings are all GOLD –They do not have Gemstones |
$625 |
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| PART 7 |
OPTIONAL FEATURES ALL RINGS IN 10K YELLOW GOLD UNLESS OTHERWISE SPECIFIED |
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14K Gold ______Yellow or _____White |
Add $100 |
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Please engrave initials ___________ or____________________________________ inside ring band Up to 24 spaces/characters engraved on Gemstone rings Only 16 spaces/characters engraved on Insignia rings. |
Add $ 20 |
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| 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 $ 50 US |
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| 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:__________________
857 E. White Mountain Blvd. - Pinetop, AZ 85935
Phone/Fax: 1-800-544-9706 - Website:
www.tjjewelry.comThank you for your order, we look forward to doing business with you