Stoneleigh Rally Challenge Awards Purple Submission

Purple Submission Form

Stoneleigh Rally Challenge Awards
Use the tab key to move between fields. Once you have completed the form press the Submit button and it should take you to a "Thank you" page to confirm your submission.
Handler's Name *
(As you want it to appear on your certificate)
Age (if under 18)
Type a question

If under 16 years of age I confirm that I have my parent's permission to apply for this award
Dog's Pet Name *
Dog's Registered Name
(Optional)
Breed of Dog
Dog's Age (in years and months, months only for 18 months and under) *
Puppies must be 4 months old to take part
Email
example@example.com
Please tell us where to send your award:

Street Address

Street Address Line 2

Town City/County

Postal / Zip Code
Country
(If not UK - please ensure you pay the overseas fee)
Please enter the square numbers you have filmed.

Five connected squares, one from each row.
Square 1 *
(from the 1st row, square numbers 1-7)
Square 2 *
(from the 2nd row, square numbers 8-14)
Square 3 *
(from the 3rd row, square numbers 15-21)
Square 4 *
(from the 4th row, square numbers 22-28)
Square 5 *
(from the bottom row, square numbers 29-35)
URL Link for your video or playlist *
We recommend using a service such as YouTube to upload your videos
Do you have any notes regarding your submission?
I wish to apply for the Stoneleigh Rally Purple Challenge Award. I will respect the decisions of the Assessors. I understand that only one square can be be resubmitted FOC and after that I will have to pay a resubmission fee *

I agree
Signature *
(Please type your name in the box to electronically sign this form. )
To pay by PayPal please select one of these two options. If you have already paid for your entry or don't have PayPal then choose the "Alternative Payment" option below.
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UK Submission Fee Purple Submission Fee - UK rate
£ 12.00 GBP

Overseas Submission Fee Purple Submission for non-UK residents. NOTE - if you would rather have a digital certificate without Award ribbon please choose the UK rate.
£ 14.00 GBP

Total

£ 0.00 GBP
Alternative Payment

I have pre-paid or I don't have PayPal and will contact Stoneleigh Rally for payment details, I understand that my submission is not confirmed until my fee is received.
Once you have clicked the "Submit" button it will take you to a "Thank you" page. If you don't see this page make sure you have filled in all the required fields (marked with a red asterix).
Should be Empty:

Purple Submission Form

Please enter the square numbers you have filmed.