YOUR RING ORDER SUMMARY

Date: 1/17/2011 Conf: # 38157946-104504 Exp. Date: 6/30/2011

Name: Jacob Hoen Customer #: 03997000
Address: 11273 eastwood avenue se School: Delano High School
delano, MN 55328 Phone: 9529553448
Email: Dhoen@frontiernet.net
Ring Choice Size Grad Year Outside Initials Accent Stone(s) $ Add On
1
Tribute (A11) - Men's 10.5 13
Metal Choice Metal Finish Palm Side
2
White Lustrium® Antique (traditional) Smooth Band (traditional)
Inside Engraving Other / Stone Band Personalization (A39/A40/T31/T32)
3
JGH
Ring Side 1 Raised Name Number Position Diamond $ Add On
4 Yeardate
School Mascot 2013
Ring Side 2 Raised Name Number Position Diamond $ Add On
Yeardate
Cross Country and Track F28 JACOB
Stone Color / Icon 1 (L45) Stone Option/Cut Encrusted / Top Initial DuraColor
5
May Shamrock Spinel Facet Premier
2nd Stone Color / Icon 2 (L45) Special Instructions (office use only)

OFFICE USE ONLY (shaded areas) PC Initials

PRICING $ US $232.99
Crest Ask about payment options available
JPP CUS SQT Added Product: _____ _____ _____

Ring Protection Plan _____ _____ Check Number

_____ _____ _____
STANDARD PLAN - 4 YEARS (INCLUDED)
_____ _____ _____
Jostens accepts Visa, MasterCard, Discover and American Express HANDLING US $5.99
Circle One: | Paid in Full | Jostens J-Pay™ | Deposit Only |
SUBTOTAL
Credit Card Amount $ ___ ___ ___ . ___ ___ Exp. Date: ___ ___ / ___ ___
TAX
Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
TOTAL
Signature: ______________________________________________________________
AMOUNT PAID
This is a customized product. Cardholder understands payment(s) may be
charged before products are delivered. Please allow 6 - 8 weeks for delivery. BALANCE DUE

............................................................................................
CONSUMER RECEIPT Name: Jacob Hoen Confirmation Number: 38157946-104504
Sales Rep Name:.Brad Fowler Fowler Recognition Phone:952-974-0800 Email:brad.fowler@jostens.com
Tribute (A11) - Men's, Metal Choice=White Lustrium® Metal Finish=Antique (traditional) Stone Color=May Shamrock Spinel Stone Options=Facet Premier Ring
Side 1=School Mascot:2013 Ring Side 2=Cross Country and Track F28:JACOB Inside Engraving=Initials:JGH Palm Side=Smooth Band (traditional) Graduation
Yeardate=2013 Ring Size=10.5 Ring Protection Plan=Standard Plan - 4 years (included)

Select One: _____ Accent Stones TOTAL

Paid in Full _____ S1 Grad YR Dia
AMOUNT PAID
Jostens J-Pay? _____ S2 Grad YR Dia
Deposit Only _____ P.C. Crest BALANCE DUE
You may cancel this order within 3 business days from its placement without charge; thereafter cancellations will be subject to a $75 cancellation fee. You may change this
order within 7 business days from its placement for no additional charge and within 8 to 14 business days for a $25 charge. No changes are allowed after 14 business days from
placement of this order. NOTE: Shipping charges may be added at time of order.
Order is subject to audit. Computational errors will be corrected on invoice. Orders are subject to acceptance by Jostens.
Tribute (A11) ­ Men's