CBC 2017 STATE FOOTBALL RINGS
PLEASE COMPLETE AS MUCH AS POSSIBLE Orders accepted Tuesday & Wednesday, 12/12 &13/17 (Sizing at school on Tuesday & Wednesday)
If you miss us at school please contact Ashley to schedule an appointment. 314-961-8875
Office Location 9804 Manchester Road in Rock Hill, MO 63119
CBC State Football Ring
First Name *
Your answer
Last Name *
Your answer
Street address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone *
Please provide your cell NUMBER AND the PROVIDER you have cell SERVICE with (eg. ATT, SPRINT etc.)
Your answer
Billing email address *
Parents email
Your answer
Ring size
will be completed at school or my office
Your answer
WHAT STYLE (Ring Body) samples will be on display at school
NAME ON THE SIDE OF THE RING *
Usually your last name (12 characters max)
Your answer
Jersey Number *
Your answer
Abbreviation of your position *
6 characters max
Your answer
ENGRAVING ON INSIDE OF THE RING *
Usually your full name
Your answer
Payment Choices *
Payment Options (Checks payable to Jostens) *
Check # PAYABLE TO JOSTENS
Your answer
Name on Credit Card
Your answer
Credit Card Number
All card records will be destroyed after processing
Your answer
Credit Card Expiration Date
Your answer
CVV Code
3 digits on the back of the card
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service