Rodenberger Funeral Home Order date: Shipped date: Flower Jewelry Order Form Received date: Paid by: Date paid: Name of Purchaser/Family:______Address: ______Phone number to be reached at: ______

1. Rosary - $80.00 (add bead caps $4.00) 17. Vial - $50.00 (18") (Seals Flowers) 2. Wedding Rosary - $190.00 18. Double - $30.00 (add to own chain) 3. Pocket Rosary - $55.00 19. Heart Pandora Pendant - $40.00 (add to own chain) 4. Birthstone Rosary - (Swarovski crystals) 20. - $75.00 (size 6, 7, 8,9, & 10) 5. Generation Rosary - (Swarovski crystals) 21. S.S. Pandora - $50.00 6. - $55.00 (self-adjustable) 22. Dangle Earrings - $30.00 7. Rosary Bracelet - $55.00 (self-adjustable) 23. S.S. Post Earrings - $30.00 8. Link Bracelet - $55.00 (self-adjustable) 24. Women or Men's Sun Catcher - $55.00 9. Pandora Style Bracelet - $75.00 (order size larger) 25. Car Cross - $40.00 10. Pandora Style Bead - $20.00 26. Rear View Mirror Rosary - $60.00 11. S.S. Pandora Dangle Bead - 27. Beaded Mirror Cross - $40.00 12. Rose Cuff Bracelet - (size 7"-7 %") 28. Bookmark with or without Charm - $30.00 13. Plain Bracelet - $50.00 (self-adjustable-no charms) 29. Women or Men's Key Chain - $35.00 14. Pendant Necklace - $40.00 (18" or 20") 30. Pandora Style Key Chain - $40.00 15. Link Necklace - $70.00 (self-adjustable) 31. Guardian Angel Key Chain - $40.00 16. S.S. Beaded Necklace - (16,18,20,22, 24,26") 32. Heart Key Chain - $40.00 (Pandora bead in middle) ($70.00, $80.00, $90.00, $100.00, $110.00, & $120.00) 33. Men's Tie Tack-$25.00 S.S. = Sterling 34. Men's Tie Chain - $30.00 *Add bead caps to a rosary for $8.00 35. Beads - $2.00 each *Add bead caps to any other item for $4.00 Some items you can get in plated for $10.00

ltem# Quantity Color of Flower Petals Male or Female/comments Total

Subtotal Sales tax is 7.25% (subtotal x .0725) + subtotal = Total Total (3 Roses for Rosary, 2 Roses for Pandora, 1 Rose for Necklace, Bracelet, Suncatcher, and Ring. 5 Tie Tac's or Earings per rose)

Make Checks to : Rodenberger Funeral Home, Inc. 1010 Westmoreland Ave. PO Box 166 Napoleon, Ohio 43545 Phone number: 419-592-2333 Fax number: 419-592-1840