Additional Brewer(s) _______________________________________________________________________________

 
Street Address ___________________________________________________________________________________

 
City ___________________________________________ State ________________________ Zip ________________

 
Country ________________________________________ E-mail __________________________________________

 
Phone (h) (______)________________________________ Phone (w) (______) _______________________________

Are you a member of an AHA Registered Homebrew Club?   Yes No

 
If so, what is its name? ______________________________________________________ (Please do not abbreviate.)

Name of Brew ___________________________________________________________________________________

 
Category (print full name) __________________________________________________________________________

 
Subcategory (print full name) _______________________________________________________________________

 
Category (No.) ________ Subcategory (a-g) ________ Special Ingredients/Classic Style: _________________________

For Mead and Cider (check one):	Dry	Medium	Sweet
For Mead and Cider (check one):	Sparkling	Still

SPECIAL INGREDIENTS:
If you have entered in any of the following categories 20c, 21, 22, 23b, 24, 25, 26, 27, 28b, 28c, 29 refer to part II of the Rules and Regulations and the BJCP Guide to Beer Styles at www.beertown.org for instructions on filling out this table. The judges will use this important information for evaluating entries in these categories. Leave this table blank if you have not entered the above categories. Entrants of Historical Beers are asked to provide the historical beer style and information on the style profile and history as an aid to judges.

Classic Style (if applicable) ________________________________________________________________________

 
Special Ingredient(s) _____________________________________________________________________________