1,000 Mile Club Alaska

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1000 Mile Club (Alaska)
Registration & Jacket Order Form

The 1000 Mile Club is the premier membership level of the Yukon Quest.

2008 Member Benefits include:

- Columbia Jacket or Fleece with your Name, sponsored Mile# and 1000 Mile Club custom embroidery
- 1000 Mile Club Pin, Yukon Quest Membership card and patch
- One vote at the 2008 Annual General Meeting
- Quarterly electronic Newsletter Subscription

1,000 Mile Club w/Fleece Jacket $200.00 + s&h*
- Individual membership package
- 1,000 Mile Club pin
- Special Recognition in Race Annual

* required

	1,000 Mile Club w/Limited Edition Jacket $350.00 + s&h*
	1,000 Mile Club -renewal with fleece jacket: $175.00 + s&h*
	1,000 Mile Club -renewal with Ltd. Edition jacket: $250.00 + s&h*
	Renewal of mile, no jacket: $75.00

	2^nd jacket, same mile : fleece: $175.00 +s&h*
	2^nd jacket, same mile: Limited Edition $250 + s&h*

Embroidery:
1^st Line / Name: *	Size:*
Please enter the 1st Line you would like on the jacket. Please enter the 1st Line you would like on the jacket.	Please select a Jacket Size.
2^nd Line / Business Name (if desired):

1^st of YQ Mile: *	2^nd Choice of YQ Mile: *
Please enter a number between 1 and 1000. Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000	Please enter a number between 1 and 1000. Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000 Please enter a number between 1 and 1000
Name: *
Please enter your Name. Please enter your Name.
Address Line 1:(Street address, PO box, company name, c/o)
Please enter your Address. Please enter your Address.

Address Line2:(Apartment, suite, unit, building, floor, etc.)

City: *	State/Region/Province: *	Zip/Postal Code: *
Please enter your City. Please enter your City.	Please enter your State/Region/Province. Please enter your State/Region/Province.	Please enter your Postal code. Please enter your Postal code.

Country: *

Please enter your Country.
Please enter your Country.

Phone Number:	Alt. Phone Number:	Fax:

Email Address: *

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I would like to receive the E-Bulletin - news and updates emailed approx. 12 times a year.

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Shipping & Handling:

to U.S. address	$20
to International address	$40

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1,000 Mile Club Alaska