Online Payment - Stallion Nomination Form

Use this form if you have submitted payment using our online payment service. Please remember to send stallion information to nominations@fivestarfuturity.com so that we can place your stallion on our website.  Stallion nomination fee will be determined by the date paypal payment is received.

______ $100.00 Nomination if postmarked by February 15th
______ $150.00 Nomination if postmarked between February 15th and April 15th
______ $200.00 Nomination if postmarked between April 16th and August 15th

                                    NO NOMINATIONS AFTER AUGUST 15TH!

                                                             NO EXCEPTIONS

Please provide the following contact information: All information is required.

Nominator Name *required
Address *required
City, State *required
Zipcode *required
Cell Phone *required
Home Phone *required
Social Security Number *required
E-mail
Website

Please provide the following product information:

Stallion Name *required
Registered with *required
   

Please indicate form of payment. Payment MUST be received by deadline either by credit card or snail mail. No entry will be valid until payment is received.
Check One

I am sending a check or money order
I am paying by Credit Card Online


 

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Revised: 02/08/08