NATIONAL AWARD SUBMISSION

CENTER NAME: *

CENTER #: *

CENTER ADDRESS: *

CITY: *

COUNTRY: *

STATE: *

ZIP CODE: *

COMPETITION NAME: *

COMPETITION #: *

COMPETITION OFFICIAL: *

COMPETITION OFFICIAL ADDRESS: *

CITY: *

STATE: *

ZIP CODE: *

COMPETITION TYPE: (CHECK ONE) *

LEAGUE TOURNAMENT INTER-SCHOLASTIC MODIFIED FORMAT (SCORESHEET ATTACHED)

BOWLER INFORMATION

FIRST NAME: *

LAST NAME: *

ADDRESS: *

CITY: *

STATE: *

ZIP CODE: *

USBC # *

DATE OF BIRTH: *

PHONE NUMBER: *

EMAIL: *

GENDER: *

MALE FEMALE

BOWLED WITH: *

RIGHT HAND LEFT HAND

DATE BOWLED: *

AVERAGE: *

NUMBER OF GAMES: *

GAME 1: *

GAME 2: *

GAME 3: *

SERIES: *

BALL MANUFACTURER: *

BALL MODEL: *

SERIAL NUMBER ON BALL: *

YES NO

WERE ALL RULES OBSERVED WHEN SCORE WAS BOWLED? *

YES NO

WAS/WERE THE GAME(S) PRE/POST BOWLED?: *

YES NO

USBC LIFETIME ACHIEVEMENTS

CHOOSE YOUR AWARD: *

300 GAME 800 SERIES

PLEASE NOTE IF ACHIEVEMENT IS: *

FIRST ADULT LIFETIME ACHIEVEMENT FOR THIS SCORE MULTIPLE ACHIEVEMENTS

FOR FIRST TIME AWARDS COMPLETE OPTIONS BELOW. IF AWARD IS MULTIPLE ACHIEVEMENT SELECT N/A FOR ALL OPTIONS BELOW

MEN'S PRESTIGE RING

FINGER SIZE:

MEN'S METAL CHOICE (CHOOSE ONE): *

SILADIUM (NO CHARGE) GOLDEN SILADIUM ($55.00) SILADIUM TWO-TONE ($220.00) 10K YELLO GOLD ($780.00) 14K YELLOW GOLD ($1090.00) N/A

WOMEN'S PRESTIGE RING

FINGER SIZE:

WOMEN'S METAL CHOICE *

SILADIUM (NO CHARGE) GOLDEN SILADIUM ($55.00) SILADIUM TWO-TONE ($172.00) 10K YELLOW GOLD ($530.00) 14 YELLOW GOLD ($655.00) N/A

MENS/WOMENS RING PERSONALIZATION CHOICES

PRESTIGE PANEL/STONE CHOICE (CHOOSE ONE): *

SIGNET PANEL (NO CHARGE) CZ ZENITH STONE ($55.00) 10K YELLOW PANEL ($75.00) DIAMOND ZENITH STONE ($150.00) N/A

PRESTIGE TOP PIN CHOICE: *

CLASSIC PIN (NO CHARGE) PERSONALIZED PIN ($10.00) DIAMOND ACCENT PIN ($60.00) N/A

CRYSTAL AWARDS/PLAQUES

CRYSTAL AWARD/PLAQUE (CHOOSE ONE): *

300 GAME CRYSTAL AWARD 800 SERIES CRYSTAL AWARD 300 GAME PLAQUE 800 SERIES PLAQUE N/A

DONATION OPTIONS

DONATION OPTIONS (CHOOSE ONE): *

HALL OF FAME EARL ANTHONY FUND BOWLERS TO VETERANS LINK (BVL) SUSAN G. KOMEN FOR THE CURE YOUTH EDUCATION SERVICES (YES FUND) N/A

WOMEN'S PREMIER RING IN SILADIUM WITH CZ STONES

UPGRADES AVAILABLE: *

10K YELLOW GOLD ($392.00) 14K YELLOW GOLD ($495.00) DIAMOND ACCENTS ($60.00) LAB-CREATED RUBY - 300 GAME ($25.00) GENUINE AMETHYST - 800 SERIES ($25.00) N/A

MULTIPLE DESIGN PAVE PANEL

MULTIPLE DESIGN PAVE PANEL *

300 800 BOWLING BALL DESIGN STERLING SILVER WITH CZ ($40.00) STERLING SILVER WITH DIAMOND ($60.00) 10K YELLOW GOLD WITH CZ ($60.00) 10K YELLOW GOLD WITH DIAMONDS ($100.00) N/A

SUBMITTED BY: *

USBC #: *

PLEASE SHIP AWARD TO: *

THE ABOVE ADDRESS (I.E. DIRECTLY TO BOWLER) ASSOCIATION LEAGUE OFFICIAL OTHER

SEND CONFIRMATION EMAIL TO: *

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USBC NATIONAL AWARD SUBMISSION