Havana Sanction Request

Name of Club:____________________________________________________

Show Date:________________  Place:________________________________

Show Secretary:___________________________________________________

Show Secretary Address:____________________________________________

________________________________________________________________

ARBA Open Sanction Number:________________________________________

ARBA Youth Sanction Number:________________________________________

Will the club be using computer program?          Yes                 No

If yes, can the Havana sanction numbers be e-mailed?

If yes, e-mail address:______________________________________________

Sanctions are:  Open $7.00    Youth $5.00    Both Open & Youth $10.00

Mail request to:

Suzanne Hemsath

HRBA

7677 W Jefferson Rd
Magna, UT  84044