* Indicates a Required Field.
Step 1 - Purchase Item(s)
Sponsorships
Qty: --- 1
Full Throttle Sponsorship - 5,000.00
Amount:
Two pages, color, in the Air Race Classic (ARC) Program
Logo and name displayed on the ARC website; hot-link to sponsor's website
Recognition at ARC banquets, the ARC Program, and eFlyby Newsletter
Two complimentary tickets for the Start banquet and the Terminus banquet
Logo and sponsor name displayed on banner at each race stop
Qty: --- 1
Fly By Sponsorship - 2,500.00
Amount:
One page, color, in the ARC Program
Logo and name displayed on the ARC website; hot-link to sponsor's website
Recognition at ARC banquets, the ARC Program and eFlyby Newsletter
Two complimentary tickets for either the Start or the Terminus banquet
Logo and sponsor name displayed on banner at each race stop
Qty: --- 1
Tailwinds Sponsorship - 1,000.00
Amount:
Half-page, color, in the ARC Program
Logo and name displayed on the ARC website
Recognition at ARC Banquets, the ARC Program and eFlyby Newsletter
Logo and sponsor name displayed on banner at each race stop
Qty: --- 1
Take Off Sponsorship - 500.00
Amount:
Quarter page, color, in the ARC Program
Logo and name displayed on the ARC website
Qty: --- 1
Pilot Sponsorship - 300.00
Amount:
Business card ad, color, in the ARC Program
Logo and sponsor name displayed on the ARC website
Program Advertising
Qty: --- 1
Quarter Page Advertisement - 500.00
Quarter page, color, in the ARC Program
Qty: --- 1
Business Card Advertisement - 300.00
Business card ad, color, in the ARC Program
Qty: --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
CHIRP Advertisement - 50.00/ea
Show your support of the ARC or favorite Race Team with a 140 character CHIRP in the ARC Program
ARC will contact you to confirm CHIRP copy
Other Sales
Qty: --- 1
ARC Patch Qty 1 - 3.00 (plus shipping of $1.50 ea, minimum rate $1.50) Choose between 90th Anniversary or regular ARC logo
$3/ea
Qty: --- 1 2 3 4 5
ARC Patch (2/$5) - 5.00/ea (plus shipping of $2.50 ea, minimum rate $2.50)
Choose between ARC logo or 90th Anniversary (or one of each!)
Qty: --- 1 2 3 4 5
ARC Note Cards - 10.00/ea (plus shipping of $3.00 ea, minimum rate $3.00) Set of 5 cards with envelopes
Qty: --- 1
ARC Route Charm - 10.00 (plus shipping of $2.00 ea, minimum rate $2.00) LIMITED CHARMS AVAILABLE!
If purchasing more than one, email finance@airraceclassic.org for shipping discount.
Qty: --- 1 2 3 4 5 6 7 8 9 10
ARC Survival Kit-Pickup - 10.00/ea
Pre-order survival kit for pick up at the Start.
Qty: --- 1 2 3 4 5 6 7 8 9 10
Ponytail Hat w/ARC logo - 20.00/ea (plus shipping of $3.00 ea, minimum rate $3.00)
TOPTIE Ponytail Hat Quick Dry Baseball Cap Unisex Outdoor Sports Cap
Quick-Dry Nylon & Polyester
Criss-Cross Ponytail Slot
Mesh Side & Back
Adjustable Hook & Loop Strap
Match Lining & Sweatband
Unstructured, Breathable & Lightweight
Perfect for Sports and Outdoors
Qty: --- 1 2 3 4 5 6 7 8 9 10
ARC Survival Kit-For Shipment - 20.00/ea (plus shipping of $10.00 ea, minimum rate $10.00)
Survival Kit to be shipped. For shipping discount on multiple quantities, please email finance@airraceclassic.org.
Qty: --- 1 2 3 4 5 6 7 8 9 10
Eras T-Shirt - 25.00/ea (plus shipping of $2.50 ea, minimum rate $2.50)
The Eras shirt is new in 2024 and represents several decades of women's air racing.
Qty: --- 1
Charles River "Legend" Windshirt, Black, Women's - 45.00 (plus shipping of $10.00 ea, minimum rate $10.00)
*100% Polyester Microtech Microfiber with 100% Nylon Lining for easy on/off (5.31 oz./yd2)
*Wind & water-resistant fabric offers protection from the elements
*Raglan sleeve for wider range of motion
*V-neck styling with rib knit trim at neck and cuff with contrast stripe
*Brushed microfiber twill has a soft hand feel
Qty: --- 1
Charles River "Legend" Windshirt, Black, Men's - 50.00 (plus shipping of $10.00 ea, minimum rate $10.00)
*100% Polyester Microtech Microfiber with 100% Nylon Lining for easy on/off (5.31 oz./yd2)
*Wind & water-resistant fabric offers protection from the elements
*Raglan sleeve for wider range of motion
*V-neck styling with rib knit trim at neck and cuff with contrast stripe
*Brushed microfiber twill has a soft hand feel
Qty: --- 1
ARC Number Fee - 125.00 Single Year Purchase - ARC Race Number
Reserve your favorite Racer Number for your Team!
Qty: --- 1
Hiring Fair - 300.00 Booth space for annual hiring fair.
Amount:
The next hiring fair will be in Loveland, CO on Sunday, June 23, 2024, at 1pm ET.
Qty: --- 1
ARC Race Number - 500.00 for 5 years
Reserve your favorite race number for 5 years and save $125 over a single year purchase
Qty: --- 1
ARC Race Number - 650.00 for years 6-10
Renew your favorite race number for 5 more years
Must purchase years 1-5 separately
Qty: --- 1
ARC Race Number - 800.00 for years 11-15
Renew your favorite race number for 5 more years
Must purchase years 1-5 and 6-10 separately
Qty: --- 1
ARC Race Number - 1,000.00 for years 16-20
Renew your favorite race number for a final 5 years
Must purchase years 1-5, 6-10, and 11-15 separately
Qty: --- 1
Banquet Table Sponsor - 2,000.00
Sponsor a table for 8 at either Welcome Banquet at Start or Awards Banquet at Terminus.
Qty: --- 1
Other not for race registration - please refer to Team Registration Instructions
Amount:
Step 2 - Donation (optional)
How much would you like to donate?
Donation Amount:
Please select... $25 $50 $100 $250 $500 Other Other: $
While your gift in any amount is appreciated, the minimum online donation is $25.00.
Would you like this to be a recurring monthly donation? (optional) Yes, charge me the designated amount monthly, on the 15th of the month
Tribute Gift:
In Memory/Honor Of
Name :
Please acknowledge my gift to the following:
Name:
Address:
Address 2:
City:
Country:
Afghanistan (AF) Aland Islands (AX) Albania (AL) Algeria (DZ) American Samoa (AS) Andorra (AD) Angola (AO) Anguilla (AI) Antarctica (AQ) Antigua and Barbuda (AG) Argentina (AR) Armenia (AM) Aruba (AW) Australia (AU) Austria (AT) Azerbaijan (AZ) Bahrain (BH) Bangladesh (BD) Barbados (BB) Belarus (BY) Belgium (BE) Belize (BZ) Benin (BJ) Bermuda (BM) Bhutan (BT) Bolivia (BO) Bonaire, Sint Eustatius and Saba (BQ) Bosnia and Herzegovina (BA) Botswana (BW) Bouvet Island (BV) Brazil (BR) British Indian Ocean Territory (IO) Brunei (BN) Bulgaria (BG) Burkina Faso (BF) Burundi (BI) Cambodia (KH) Cameroon (CM) Canada (CA) Cape Verde (CV) Cayman Islands (KY) Central African Republic (CF) Chad (TD) Chile (CL) China (CN) Christmas Island (CX) Cocos (Keeling) Islands (CC) Colombia (CO) Comoros (KM) Congo (CG) Cook Islands (CK) Costa Rica (CR) Cote D'Ivoire (Ivory Coast) (CI) Croatia (HR) Cuba (CU) Curaçao (CW) Cyprus (CY) Czech Republic (CZ) Democratic Republic of the Congo (CD) Denmark (DK) Djibouti (DJ) Dominica (DM) Dominican Republic (DO) East Timor (TL) Ecuador (EC) Egypt (EG) El Salvador (SV) Equatorial Guinea (GQ) Eritrea (ER) Estonia (EE) Ethiopia (ET) Falkland Islands (FK) Faroe Islands (FO) Fiji Islands (FJ) Finland (FI) France (FR) French Guiana (GF) French Polynesia (PF) French Southern Territories (TF) Gabon (GA) Gambia The (GM) Georgia (GE) Germany (DE) Ghana (GH) Gibraltar (GI) Greece (GR) Greenland (GL) Grenada (GD) Guadeloupe (GP) Guam (GU) Guatemala (GT) Guernsey and Alderney (GG) Guinea (GN) Guinea-Bissau (GW) Guyana (GY) Haiti (HT) Heard Island and McDonald Islands (HM) Honduras (HN) Hong Kong S.A.R. (HK) Hungary (HU) Iceland (IS) India (IN) Indonesia (ID) Iran (IR) Iraq (IQ) Ireland (IE) Israel (IL) Italy (IT) Jamaica (JM) Japan (JP) Jersey (JE) Jordan (JO) Kazakhstan (KZ) Kenya (KE) Kiribati (KI) Kosovo (XK) Kuwait (KW) Kyrgyzstan (KG) Laos (LA) Latvia (LV) Lebanon (LB) Lesotho (LS) Liberia (LR) Libya (LY) Liechtenstein (LI) Lithuania (LT) Luxembourg (LU) Macau S.A.R. (MO) Macedonia (MK) Madagascar (MG) Malawi (MW) Malaysia (MY) Maldives (MV) Mali (ML) Malta (MT) Man (Isle of) (IM) Marshall Islands (MH) Martinique (MQ) Mauritania (MR) Mauritius (MU) Mayotte (YT) Mexico (MX) Micronesia (FM) Moldova (MD) Monaco (MC) Mongolia (MN) Montenegro (ME) Montserrat (MS) Morocco (MA) Mozambique (MZ) Myanmar (MM) Namibia (NA) Nauru (NR) Nepal (NP) Netherlands (NL) New Caledonia (NC) New Zealand (NZ) Nicaragua (NI) Niger (NE) Nigeria (NG) Niue (NU) Norfolk Island (NF) North Korea (KP) Northern Mariana Islands (MP) Norway (NO) Oman (OM) Pakistan (PK) Palau (PW) Palestinian Territory Occupied (PS) Panama (PA) Papua new Guinea (PG) Paraguay (PY) Peru (PE) Philippines (PH) Pitcairn Island (PN) Poland (PL) Portugal (PT) Puerto Rico (PR) Qatar (QA) Reunion (RE) Romania (RO) Russia (RU) Rwanda (RW) Saint Helena (SH) Saint Kitts and Nevis (KN) Saint Lucia (LC) Saint Pierre and Miquelon (PM) Saint Vincent and The Grenadines (VC) Saint-Barthelemy (BL) Saint-Martin (French part) (MF) Samoa (WS) San Marino (SM) Sao Tome and Principe (ST) Saudi Arabia (SA) Senegal (SN) Serbia (RS) Seychelles (SC) Sierra Leone (SL) Singapore (SG) Sint Maarten (Dutch part) (SX) Slovakia (SK) Slovenia (SI) Solomon Islands (SB) Somalia (SO) South Africa (ZA) South Georgia (GS) South Korea (KR) South Sudan (SS) Spain (ES) Sri Lanka (LK) Sudan (SD) Suriname (SR) Svalbard and Jan Mayen Islands (SJ) Swaziland (SZ) Sweden (SE) Switzerland (CH) Syria (SY) Taiwan (TW) Tajikistan (TJ) Tanzania (TZ) Thailand (TH) The Bahamas (BS) Togo (TG) Tokelau (TK) Tonga (TO) Trinidad and Tobago (TT) Tunisia (TN) Turkey (TR) Turkmenistan (TM) Turks and Caicos Islands (TC) Tuvalu (TV) Uganda (UG) Ukraine (UA) United Arab Emirates (AE) United Kingdom (GB) United States (US) United States Minor Outlying Islands (UM) Uruguay (UY) Uzbekistan (UZ) Vanuatu (VU) Vatican City State (Holy See) (VA) Venezuela (VE) Vietnam (VN) Virgin Islands (British) (VG) Virgin Islands (US) (VI) Wallis and Futuna Islands (WF) Western Sahara (EH) Yemen (YE) Zambia (ZM) Zimbabwe (ZW)
* State:
Please Select Alabama (AL) Alaska (AK) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Florida (FL) Georgia (GA) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennsylvania (PA) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY) Armed Forces (AE) Armed Forces Americas (AA) Armed Forces Pacific (AP) Alberta (AB) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrado (NL) Nova Scotia (NS) Northwest Territories (NT) Nunavut (NU) Ontario (ON) Prince Edward Island (PE) Quebec (QC) Saskatchewan (SK) Yukon (YT) American Samoa (AS) Guam (GU) Marshall Islands (MH) Northern Mariana Islands (MP) Palau (PW) Puerto Rico (PR) Virgin Islands (VI) Other (NA)
Province:
ZIP/Postal Code:
Additional
Instructions:
Designated Fund:
General Fund - to support ARC's charitable purposes today
Endowment Fund - to support ARC's long-term financial security into the future
Step 3 - Shipping Information
Title:
* First Name:
* Last Name:
Spouse Name:
Company Name:
* Address:
Address 2:
* City:
* Country:
Afghanistan (AF) Aland Islands (AX) Albania (AL) Algeria (DZ) American Samoa (AS) Andorra (AD) Angola (AO) Anguilla (AI) Antarctica (AQ) Antigua and Barbuda (AG) Argentina (AR) Armenia (AM) Aruba (AW) Australia (AU) Austria (AT) Azerbaijan (AZ) Bahrain (BH) Bangladesh (BD) Barbados (BB) Belarus (BY) Belgium (BE) Belize (BZ) Benin (BJ) Bermuda (BM) Bhutan (BT) Bolivia (BO) Bonaire, Sint Eustatius and Saba (BQ) Bosnia and Herzegovina (BA) Botswana (BW) Bouvet Island (BV) Brazil (BR) British Indian Ocean Territory (IO) Brunei (BN) Bulgaria (BG) Burkina Faso (BF) Burundi (BI) Cambodia (KH) Cameroon (CM) Canada (CA) Cape Verde (CV) Cayman Islands (KY) Central African Republic (CF) Chad (TD) Chile (CL) China (CN) Christmas Island (CX) Cocos (Keeling) Islands (CC) Colombia (CO) Comoros (KM) Congo (CG) Cook Islands (CK) Costa Rica (CR) Cote D'Ivoire (Ivory Coast) (CI) Croatia (HR) Cuba (CU) Curaçao (CW) Cyprus (CY) Czech Republic (CZ) Democratic Republic of the Congo (CD) Denmark (DK) Djibouti (DJ) Dominica (DM) Dominican Republic (DO) East Timor (TL) Ecuador (EC) Egypt (EG) El Salvador (SV) Equatorial Guinea (GQ) Eritrea (ER) Estonia (EE) Ethiopia (ET) Falkland Islands (FK) Faroe Islands (FO) Fiji Islands (FJ) Finland (FI) France (FR) French Guiana (GF) French Polynesia (PF) French Southern Territories (TF) Gabon (GA) Gambia The (GM) Georgia (GE) Germany (DE) Ghana (GH) Gibraltar (GI) Greece (GR) Greenland (GL) Grenada (GD) Guadeloupe (GP) Guam (GU) Guatemala (GT) Guernsey and Alderney (GG) Guinea (GN) Guinea-Bissau (GW) Guyana (GY) Haiti (HT) Heard Island and McDonald Islands (HM) Honduras (HN) Hong Kong S.A.R. (HK) Hungary (HU) Iceland (IS) India (IN) Indonesia (ID) Iran (IR) Iraq (IQ) Ireland (IE) Israel (IL) Italy (IT) Jamaica (JM) Japan (JP) Jersey (JE) Jordan (JO) Kazakhstan (KZ) Kenya (KE) Kiribati (KI) Kosovo (XK) Kuwait (KW) Kyrgyzstan (KG) Laos (LA) Latvia (LV) Lebanon (LB) Lesotho (LS) Liberia (LR) Libya (LY) Liechtenstein (LI) Lithuania (LT) Luxembourg (LU) Macau S.A.R. (MO) Macedonia (MK) Madagascar (MG) Malawi (MW) Malaysia (MY) Maldives (MV) Mali (ML) Malta (MT) Man (Isle of) (IM) Marshall Islands (MH) Martinique (MQ) Mauritania (MR) Mauritius (MU) Mayotte (YT) Mexico (MX) Micronesia (FM) Moldova (MD) Monaco (MC) Mongolia (MN) Montenegro (ME) Montserrat (MS) Morocco (MA) Mozambique (MZ) Myanmar (MM) Namibia (NA) Nauru (NR) Nepal (NP) Netherlands (NL) New Caledonia (NC) New Zealand (NZ) Nicaragua (NI) Niger (NE) Nigeria (NG) Niue (NU) Norfolk Island (NF) North Korea (KP) Northern Mariana Islands (MP) Norway (NO) Oman (OM) Pakistan (PK) Palau (PW) Palestinian Territory Occupied (PS) Panama (PA) Papua new Guinea (PG) Paraguay (PY) Peru (PE) Philippines (PH) Pitcairn Island (PN) Poland (PL) Portugal (PT) Puerto Rico (PR) Qatar (QA) Reunion (RE) Romania (RO) Russia (RU) Rwanda (RW) Saint Helena (SH) Saint Kitts and Nevis (KN) Saint Lucia (LC) Saint Pierre and Miquelon (PM) Saint Vincent and The Grenadines (VC) Saint-Barthelemy (BL) Saint-Martin (French part) (MF) Samoa (WS) San Marino (SM) Sao Tome and Principe (ST) Saudi Arabia (SA) Senegal (SN) Serbia (RS) Seychelles (SC) Sierra Leone (SL) Singapore (SG) Sint Maarten (Dutch part) (SX) Slovakia (SK) Slovenia (SI) Solomon Islands (SB) Somalia (SO) South Africa (ZA) South Georgia (GS) South Korea (KR) South Sudan (SS) Spain (ES) Sri Lanka (LK) Sudan (SD) Suriname (SR) Svalbard and Jan Mayen Islands (SJ) Swaziland (SZ) Sweden (SE) Switzerland (CH) Syria (SY) Taiwan (TW) Tajikistan (TJ) Tanzania (TZ) Thailand (TH) The Bahamas (BS) Togo (TG) Tokelau (TK) Tonga (TO) Trinidad and Tobago (TT) Tunisia (TN) Turkey (TR) Turkmenistan (TM) Turks and Caicos Islands (TC) Tuvalu (TV) Uganda (UG) Ukraine (UA) United Arab Emirates (AE) United Kingdom (GB) United States (US) United States Minor Outlying Islands (UM) Uruguay (UY) Uzbekistan (UZ) Vanuatu (VU) Vatican City State (Holy See) (VA) Venezuela (VE) Vietnam (VN) Virgin Islands (British) (VG) Virgin Islands (US) (VI) Wallis and Futuna Islands (WF) Western Sahara (EH) Yemen (YE) Zambia (ZM) Zimbabwe (ZW)
* State:
Please Select Alabama (AL) Alaska (AK) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Florida (FL) Georgia (GA) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennsylvania (PA) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY) Armed Forces (AE) Armed Forces Americas (AA) Armed Forces Pacific (AP) Alberta (AB) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrado (NL) Nova Scotia (NS) Northwest Territories (NT) Nunavut (NU) Ontario (ON) Prince Edward Island (PE) Quebec (QC) Saskatchewan (SK) Yukon (YT) American Samoa (AS) Guam (GU) Marshall Islands (MH) Northern Mariana Islands (MP) Palau (PW) Puerto Rico (PR) Virgin Islands (VI) Other (NA)
Province:
* ZIP / Postal Code:
* Phone:
* Email Address:
Please add me to the eFlyby newsletter email list.
Step 4 - Payment Information
* Payment Type:
* Card Number:
* CVV2 Number:
* Expiration Date:
01 02 03 04 05 06 07 08 09 10 11 12 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034
Step 5 - Billing Information
* First Name:
* Last Name:
* Address:
Address 2:
* City:
* Country:
Afghanistan (AF) Aland Islands (AX) Albania (AL) Algeria (DZ) American Samoa (AS) Andorra (AD) Angola (AO) Anguilla (AI) Antarctica (AQ) Antigua and Barbuda (AG) Argentina (AR) Armenia (AM) Aruba (AW) Australia (AU) Austria (AT) Azerbaijan (AZ) Bahrain (BH) Bangladesh (BD) Barbados (BB) Belarus (BY) Belgium (BE) Belize (BZ) Benin (BJ) Bermuda (BM) Bhutan (BT) Bolivia (BO) Bonaire, Sint Eustatius and Saba (BQ) Bosnia and Herzegovina (BA) Botswana (BW) Bouvet Island (BV) Brazil (BR) British Indian Ocean Territory (IO) Brunei (BN) Bulgaria (BG) Burkina Faso (BF) Burundi (BI) Cambodia (KH) Cameroon (CM) Canada (CA) Cape Verde (CV) Cayman Islands (KY) Central African Republic (CF) Chad (TD) Chile (CL) China (CN) Christmas Island (CX) Cocos (Keeling) Islands (CC) Colombia (CO) Comoros (KM) Congo (CG) Cook Islands (CK) Costa Rica (CR) Cote D'Ivoire (Ivory Coast) (CI) Croatia (HR) Cuba (CU) Curaçao (CW) Cyprus (CY) Czech Republic (CZ) Democratic Republic of the Congo (CD) Denmark (DK) Djibouti (DJ) Dominica (DM) Dominican Republic (DO) East Timor (TL) Ecuador (EC) Egypt (EG) El Salvador (SV) Equatorial Guinea (GQ) Eritrea (ER) Estonia (EE) Ethiopia (ET) Falkland Islands (FK) Faroe Islands (FO) Fiji Islands (FJ) Finland (FI) France (FR) French Guiana (GF) French Polynesia (PF) French Southern Territories (TF) Gabon (GA) Gambia The (GM) Georgia (GE) Germany (DE) Ghana (GH) Gibraltar (GI) Greece (GR) Greenland (GL) Grenada (GD) Guadeloupe (GP) Guam (GU) Guatemala (GT) Guernsey and Alderney (GG) Guinea (GN) Guinea-Bissau (GW) Guyana (GY) Haiti (HT) Heard Island and McDonald Islands (HM) Honduras (HN) Hong Kong S.A.R. (HK) Hungary (HU) Iceland (IS) India (IN) Indonesia (ID) Iran (IR) Iraq (IQ) Ireland (IE) Israel (IL) Italy (IT) Jamaica (JM) Japan (JP) Jersey (JE) Jordan (JO) Kazakhstan (KZ) Kenya (KE) Kiribati (KI) Kosovo (XK) Kuwait (KW) Kyrgyzstan (KG) Laos (LA) Latvia (LV) Lebanon (LB) Lesotho (LS) Liberia (LR) Libya (LY) Liechtenstein (LI) Lithuania (LT) Luxembourg (LU) Macau S.A.R. (MO) Macedonia (MK) Madagascar (MG) Malawi (MW) Malaysia (MY) Maldives (MV) Mali (ML) Malta (MT) Man (Isle of) (IM) Marshall Islands (MH) Martinique (MQ) Mauritania (MR) Mauritius (MU) Mayotte (YT) Mexico (MX) Micronesia (FM) Moldova (MD) Monaco (MC) Mongolia (MN) Montenegro (ME) Montserrat (MS) Morocco (MA) Mozambique (MZ) Myanmar (MM) Namibia (NA) Nauru (NR) Nepal (NP) Netherlands (NL) New Caledonia (NC) New Zealand (NZ) Nicaragua (NI) Niger (NE) Nigeria (NG) Niue (NU) Norfolk Island (NF) North Korea (KP) Northern Mariana Islands (MP) Norway (NO) Oman (OM) Pakistan (PK) Palau (PW) Palestinian Territory Occupied (PS) Panama (PA) Papua new Guinea (PG) Paraguay (PY) Peru (PE) Philippines (PH) Pitcairn Island (PN) Poland (PL) Portugal (PT) Puerto Rico (PR) Qatar (QA) Reunion (RE) Romania (RO) Russia (RU) Rwanda (RW) Saint Helena (SH) Saint Kitts and Nevis (KN) Saint Lucia (LC) Saint Pierre and Miquelon (PM) Saint Vincent and The Grenadines (VC) Saint-Barthelemy (BL) Saint-Martin (French part) (MF) Samoa (WS) San Marino (SM) Sao Tome and Principe (ST) Saudi Arabia (SA) Senegal (SN) Serbia (RS) Seychelles (SC) Sierra Leone (SL) Singapore (SG) Sint Maarten (Dutch part) (SX) Slovakia (SK) Slovenia (SI) Solomon Islands (SB) Somalia (SO) South Africa (ZA) South Georgia (GS) South Korea (KR) South Sudan (SS) Spain (ES) Sri Lanka (LK) Sudan (SD) Suriname (SR) Svalbard and Jan Mayen Islands (SJ) Swaziland (SZ) Sweden (SE) Switzerland (CH) Syria (SY) Taiwan (TW) Tajikistan (TJ) Tanzania (TZ) Thailand (TH) The Bahamas (BS) Togo (TG) Tokelau (TK) Tonga (TO) Trinidad and Tobago (TT) Tunisia (TN) Turkey (TR) Turkmenistan (TM) Turks and Caicos Islands (TC) Tuvalu (TV) Uganda (UG) Ukraine (UA) United Arab Emirates (AE) United Kingdom (GB) United States (US) United States Minor Outlying Islands (UM) Uruguay (UY) Uzbekistan (UZ) Vanuatu (VU) Vatican City State (Holy See) (VA) Venezuela (VE) Vietnam (VN) Virgin Islands (British) (VG) Virgin Islands (US) (VI) Wallis and Futuna Islands (WF) Western Sahara (EH) Yemen (YE) Zambia (ZM) Zimbabwe (ZW)
* State:
Please Select Alabama (AL) Alaska (AK) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Florida (FL) Georgia (GA) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennsylvania (PA) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY) Armed Forces (AE) Armed Forces Americas (AA) Armed Forces Pacific (AP) Alberta (AB) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrado (NL) Nova Scotia (NS) Northwest Territories (NT) Nunavut (NU) Ontario (ON) Prince Edward Island (PE) Quebec (QC) Saskatchewan (SK) Yukon (YT) American Samoa (AS) Guam (GU) Marshall Islands (MH) Northern Mariana Islands (MP) Palau (PW) Puerto Rico (PR) Virgin Islands (VI) Other (NA)
Province:
* ZIP / Postal Code:
* Phone: