Dressage and Combined Test

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Your contact information:
Rider Name: Rider NCDCTA #	Junior Senior
Address: Email/Phone: .  Horse/Owner/NCDCTA #:
Tests:
Please Choose your Dressage or Combined Test: (Hold Control for multiple selections)	Intro A Intro B Training 1 Training 2 Training 3 Training 4 First 1 First 2 First 3 First 4 Second 1 Second 2 Second 3 Second 4 None Maiden Beginner Novice Novice Training Preliminary None
Comments/Requests:

Show Fees:  Dressage $25 per test                  Combined Test $40 per test                  Extra Show Jumping Rounds $10 per round                  On-line Convenience Fee $2                  Refundable Number Fee $2                  Late Fee After December 1 $5 Please add correctly to your total fees. Fax Coggins to 1-866-343-7855 or email to millereventing@hotmail.com