2007 MIDWEST GOLD CHALLENGE NOMINATION FORM

Date:____________

Name of Horse:_________________________________

PHBA No. ___________________

Exhibitor:_____________________________ PHBA No._______(check) Open__ Youth__ Am___

Address:______________________________________

City/State/Zip:_________________________________

Phone:________________________________________

AWARD AREAS: (Please check each award area in which you wish to nominate)

(One form per horse or horse / rider combo)

____ Yearling Longeline ____ Halter Mares Open

____ Youth 5-9 ____ Halter Mares Amateur

____ Youth 10-13 ____ Halter Geldings Open

____ Youth 14-18 ____ Halter Geldings Amateur

____ Amateur Performance ____ Halter Stallions Open

____ Amateur Select Performance ____ Halter Stallions Amateur

____ Jr Performance Horse ____ Open Color

____ Sr Performance Horse ____ Amateur Color

____Novice Amateur Performance ____ Contesting/Gaming Horse

Nomination Fees:

# Award Areas ______ X $10.00 = _________

Signature:__________________________

Make Checks Payable to: Midwest Gold Challenge

Your points do not begin until you have a PAID nomination prior to entering the

first day of the show.

You cannot add the nomination to your show tabs.

Must have a separate check to Midwest Gold Challenge.

Mail Completed form and check to : Phil & Chris Madden, 59 Hidden River

Court, Tipton, Iowa 52772