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BIOTHANE BROW BANDS ORDER FORM
ENTER YOUR CONTACT INFORMATION:
Your contact information is for internal use only; it will not be shared with any entity.
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Name
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First
Last
Email
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
ENTER BIOTHANE BROW BAND DESCRIPTION:
Brow Band Type (Select One):
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Biothane + Leather Side Strips - 1" - Straight - for all beads
Brow Band Size (Select One)
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14" (pony)
15" (cob)
16" (horse)
17" (warmblood)
18" (draft)
Other size (complete box below)
Other Size (optional)
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Biothane Color
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Black
Chestnut
Brown
Royal Blue
Other (complete box below) (custom order)
Other Beta Biothane Color (optional)
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Side Strip Color
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Leather - Black
Leather - Light Aqua
Leather - Brown
Leather - Tan
Leather - Dark Brown Leather (matches brown Biothane)
Leather - White
Biothane - Black
Biothane - Chestnut
Biothane - Brown
Biothane - Royal Blue
Biothane - Bright Pink
Other leather or Biothane side strip color (custom order, complete box below)
Other Side Strip Color (optional)
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Bead Color(s), Sizes and/or Descriptions (use info from the website)
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If you want more than one bead color, describe how you want them arranged (1+1+1 etc., 2+2+2 etc., other. (optional)
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7. Snap Color
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Black Color
Brass Color
Silver Color
Other Custom Requests (alternate colors, alternate sizes, etc.)
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ENTER OTHER ORDER INFORMATION:
Charity to receive your donation (select one)
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Frederick County 4-H Therapeutic Riding Program (FC4HTRP)
Frederick Health Hurwitz Breast Cancer Fund
Maryland Equine Transition Service (METS) (= Owner-2-Owner)
Catoctin Chapter of PVDA
How will you pay for your brow band?
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Via check (made out to Leslie Raulin)
Via PayPal Friends & Family - contact me for instructions
Cash at a show or Blue Horse Farm (I do not have change)
Sorry, but I do not take credit cards (this is not a business) and I must receive payment before I make/mail your brow band.
How do you want to receive your brow band?
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Via snail mail (add $6.00 for P&H)
Pick up in Jefferson, MD
Pick up at a show where the brow bands are displayed
If you are ordering for a specific FC4HTRP horse or pony, enter the horse or pony name.
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YOUR COSTS:
1. Enter Your Brow Band Materials Cost ($15)
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2. Enter Custom Biothane Color Fee ($5) (optional)
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3. Enter Custom Side Strip Color ($10) (optional)
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4. Enter Your Donation Amount ($30 minimum)
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Donations larger than $30 are appreciated.
5. Postage and Handling (enter $6.00 if brow band will be mailed to you) (optional if you will pick-up)
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Total Amount You Will Pay (enter total of 1-5)
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1. Complete the information above then click "Submit the Form" below to send your request to me (Leslie Raulin).
2. Provide payment via check, PayPal, or cash (no credit cards as this is not a business):
Check
: Mail a check for the total amount, made out to
Leslie Raulin
, to:
Leslie Raulin
2027 Gapland Road
Jefferson, MD 21755
PayPal
: Send the total amount via PayPal
Friends and Family
(contact me for instructions). Since this is not a commercial endeavor you
must
use PayPal "
Friends and Family
"
Cash
: If you pay at Blue Horse Farm or a show where the brow bands are displayed. I do not have change.
I will then make your brow band, if needed, and mail it to you.
3. If you want to see / select / design / pick up your brow band in Jefferson, MD:
To see/select/design a brow band in Jefferson, MD: Email me at
[email protected]
to set up a day/time.
To pick up a brow band in Jefferson, MD: I will email you to let you know the brow band is ready, then I will place your completed brow band in a blue box on the white porch on my house porch - 2027 Gapland Road, Jefferson, MD 21755.
4. If you want to see / select / pick up your brow band at a FADS @ Blue Horse Farm or a show where the brow bands are displayed, just come to the show. Pay via check, cash (I do not have change), or PayPal.
5. I will send a check to the charity for the amount of your donation. I usually send the donations on a quarterly basis.
Your Comments and Requests (optional)
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How did you find out about Brow Bands for Charities?
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THANK YOU!
Submit the Form
Click here
to return to the Brow Bands for Charities website.
