Entry Form: ….. Central Oregon’s Blue Bucket Stampede …… include with bird entry
Name ___________________________ Date___________ Address___________________________ City __________State_______Zip__________ Phone (____)_____-_________ Cell (____)_____-________ E-mail ____________________
Band No# __________Letter__________ color_______ Band No# __________Letter__________ color_______ Band No# __________Letter__________ color_______ Band No# __________Letter__________ color_______ Band No# __________Letter__________ color_______ Band No# __________Letter__________ color_______
Total Enclosed -----------------$______________
MAKE CHECKS PAYABLE to: Paul D. Rueter Home (541) 475-7479 and Ship Birds to … 8961 NE Old Highway 97 Cell (541) 419-0590 Madras, OR 97741 e-mail……[email protected]