G.B.R.A. of I. AWARDS WISH LIST

Name: ______Div:______Amount Won:$______

Award Chairman

Tena Ziegler, 765-860-7161 or

Rhonda Haydel 317-402-2889

If you are listed in the top 10 for the year end awards, you will need to complete this list and mail it by the due date. Otherwise you will forfeit your chosen awards and receive a gift certificate instead.

There are two choices by which to receive your awards: GBRA-I will purchase your awards for you or you will purchase your awards yourself, turn in the receipts (with the awards) and will be reimbursed. Check the box that applies to you!

The items listed on the next page are only suggestions for year end awards. Please circle or highlight the items you would like and fill in the details as needed. If the items you want are not listed please write them in a blank area. Be specific, in detail, the more detail the better!

PLEASE CHECK THE BOX THAT APPLIES TO YOU!

q  I will purchase my own awards –

You do not need to fill out any more of this form, just mail it back by 2014 December Meeting

Rules for purchasing your own awards:

1. You may purchase anything you wish. You pay for them yourself and then are reimbursed by the club.

2. Mark your awards with name and division.

3. You will turn in a receipt, along with the awards you purchased no later than our Dec. meeting. (Date TBA)

4. You will be issued a reimbursement check at the meeting or banquet.

5. ALL items must be turned into Tena Ziegler or Rhonda Haydel by the December meeting. * If you fail to turn in your awards, the club will purchase a gift card from one of our tack store sponsors. (You will not be reimbursed for the items you purchased).

q I would like the awards chairman to purchase my awards for me –

Complete the “wish list form” return by the 2014 December Meeting

If your form is not turned in by the December meeting, a gift card will be purchased as your award!

*Return by the December meeting*

Tena Ziegler, 1219 N. Main St., Tipton, IN 46072 (765)860-7161

DO NOT WRITE BELOW THIS LINE - DO NOT WRITE BELOW THIS LINE - DO NOT WRITE BELOW THIS LINE

TOTAL DOLLAR AMOUNT: ______Barrels Place $ Poles Place $

2013 MEMBERHIP: ______1-D 1-D______

ENTRY COUPONS: ______2-D 2-D______

RECEIPTS AMOUNTS: ______3-D 3-D ______

PAID BANQUET: ______Total Total______

BOT Product:$______

$ Owed to GBRA: ______

$ Owed to GBRA Member: ______Grand Total ______