Your Information 
 
 
Brewery Name*
 
 
Street Address*
 
 
 
City*
 
 
State / Province*
 
 
 
Number of barrels you pledge to produce*
 
 
 
 
 
 
 
Requester's First Name*
 
 
Requester's Last Name*
 
 
 
Requester's Email*
 
 
Requester's Phone Number*
 
 
 
 
 
Products 
 
 
Please select the product(s) that you need to participate in the event. 
 
 
 
 
1. Base Malt 
 
 
Great Western Malting Superior Pilsen Malt 
GW-PILS Quantity
 
 
 
Great Western Malting Premium Two Row Malt 
GW-2ROW Quantity
 
 
 
Great Western Malting Pure California Two Row Malt*
*Only available to ship from Vancouver, WA and San Diego, CA 
GW-PCAM Quantity
 
 
 
 
 
 
Canada Malting Superior Pilsen Malt 
CM-SPIL Quantity
 
 
 
Canada Malting Co. Two Row Malt 
CM-2ROW Quantity
 
 
 
Canada Malting Co. Superior Pale Ale Malt 
CM-PALE Quantity
 
 
 
 
 
 
2. Specialty Malt 
 
Great Western Malting Light Munich Malt 
GW-LMUN Quantity
 
 
 
Great Western Malting White Wheat Malt  
GW-WWHT Quantity
 
 
 
Canada Malting White Wheat Malt 
CM-WWHT Quantity
 
 
 
Great Western Malting Dextra Pils® Malt 
GW-DEXT Quantity
 
 
 
Canada Malting Flaked Oats 
CM-FBOT Quantity
 
 
 
 
 
 
4. Yeast (Choose one) 
 
We are offering 1 x 500 gram brick of yeast for every 10 bags of malt (max. limit 8 bricks for 80 bags of malt). 
 
 
 
 
AB Biotek Pinnacle Heritage American Ale 
AB-PHAA Quantity
 
 
 
AB Biotek Pinnacle Heritage English Ale 
AB-PHEA Quantity
 
 
 
 
 

For those interested in producing a larger batch of beer, please reach out to your designated Sales Representative for assistance with placing your order.

 
 
Additional Information 
 
 
 
 
 
Does the malt you selected need to be milled?*
 
 
If YES, which specs do you need your malt milled to?
 
 
 
How would you like to receive your product? *
 
 
 
Would you like your sales rep to contact you about adding additional (non-donated) products to your order to maximize your pallet?*