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                       Year: 
					   
              Size (finger): 
			  
                             To determine your approximate ring size.
                             Wrap a piece of paper 1/4-inch wide around widest part
                             of ring finger.  Cut off ends to meet exactly.  Lay one
                             end on point 0 of chart.  Number at other end is your 
                             ring size.
							
                            
							
         Engraving (Inside): 

                       Model ---   Men       With Stone 
                                   Ladies    Solid Top 
                                   Unisex   

 Stone Selection (Synthetic) ---
              Garnet (January)             Amethyst (February)
              Aquamarine (March)           White Sapphire (April)
              Emerald (May)                Alexandrite (June)
              Ruby (July)                  Peridot (August)
              Blue Sapphire (September)    Rose Zircon (October)
              Topaz (November)             Blue Zircon (December)


                  Gold Karat ---    10K   12K   14K   18k
                                  Others please specify: 
                      Finish ---   Natural Gold   Oxidized
                                 (We Recommend OXIDIZED Finish)

                  Deposits / Payments can be made through Money Order / Cheques.	

                    Remarks: