City _____________________________________ State ___________________Zip________________

Phone (Day)_______________ (Evening) ________________ E-mail________________________________________

Are you a member of an AHA registered homebrew club? Yes / No

The club's name (Full name, do not abbreviate)___________________________________________________________

Entry Fee Enclosed  = $_____________________________________

$6.50 / entry x _______ entries = $ ____________ total

Entry Information:

Category and Subcategory (Print full names)____________________________________________________________

Category (1 - 29) Subcategory (a - g)_____________________________

Name of Brew (Optional except in Halloween theme beer category (29))________________________________________

If you have entered a beer in any category with special ingredients please complete this section. With meads please specify if dry, medium or sweet, if sparkling or still, and hydromel, standard or sake plus any varietal honeys and special ingredients. The judges will use this important information to evaluate entries in these categories.

Classic Style (if applicable)________________________________________________________________________

Special Ingredients______________________________________________________________________________

I agree to provide a recipe upon request.   Signature______________________________________________________

Entries should be sent to arrive between October 1st and October 13th, 2007 to:

The PHC % Lori Gundberg
914 10^th St S
Fargo, ND  58103
(701) 235-9330  lori@prairiehomebrewers.org 

Hoppy Halloween Bottle ID Form