To order this exquisite tribute to the Kentucky Derby, print this page
and send with $495 to:
BROWN, WATERHOUSE, KAISER JEWELERS INC.
332 W. BROADWAY - HEYBURN BLDG., STE. 205
LOUISVILLE, KY 40202 (ph. 502/583-2728)

Or, charge to my [ ] Visa [ ] Mastercard [ ] Discover
#_____________________________     Exp. Date ________

SHIP TO: NAME ___________________________________________
ADDRESS ________________________________________________
CITY/STATE/ZIP ___________________________________________

PRICE INCLUDES SHIPPING - KY RESIDENTS ADD 6% SALES TAX - PRICE SUBJECT TO CHANGE IF SILVER MARKET FLUCTUATES