Regional Specialty Order Form

Contact*

First Last

Email*

Phone*

Commemorative Wine Glass

Price: $20.00

How many Commemorative Wine Glass (es) would you like to order?

Pre-Order Catalogs

Price: $12.00

How many catalogs would you like to order?

Basket Pledge/Cash Donation

Count me in! I would like to bring a Basket/Raffle item to support this event!
I would like to make a cash donation!

Please indicate your donation by October 28, 2022.

Basket Gift Item(s)

Please list Basket/Gift Item(s) you would like to donate. List one item per line. Click the "+" button on the right to add more lines.

Cash Donation

Are you able to pledge a raffle and/or auction item?

Yes
No

Please bring day-of-show to raffle area. If you aren't able to attend but want to donate an item (or service), please contact [email protected].
Please indicate your donation by October 28, 2021.

Auction Item(s)

Pre-order Raffle Tickets

6 Tickets ($5)
15 Tickets ($12)
25 Tickets ($20)
50 Tickets ($35)
100 Tickets ($65)

NOTICE
Conformation, Obedience and Rally may ONLY be entered directly through the AKC. There is a form in the Premium List, or you may go online to services such as Infodog.com to make the entries. These entries go directly to the AKC and are not paid through the Regional Specialty. Entry fees are shown in the Premium List.

Total

$0.00

Credit Card*

Card Details

Cardholder Name

Regional Specialty Order Form

Regional Specialty Order Form

Title