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. Pilsner Malt (Choose one)
Great Western Malting Superior Pilsen Malt
GW-PILS Quantity
*
0 lbs
55 lbs
110 lbs
165 lbs
220 lbs
275 lbs
330 lbs
385 lbs
440 lbs
495 lbs
550 lbs
605 lbs
660 lbs
715 lbs
770 lbs
OR Canada Malting Co. Superior Pilsen Malt
CM-SPIL Quantity
*
0 lbs
55 lbs
110 lbs
165 lbs
220 lbs
275 lbs
330 lbs
385 lbs
440 lbs
495 lbs
550 lbs
605 lbs
660 lbs
715 lbs
770 lbs
2. Wheat Malt (Choose one)
Great Western Malting White Wheat Malt
GW-WWHT Quantity
*
0 lbs
55 lbs
110 lbs
OR Canada Malting Co. White Wheat Malt
CM-WWHT Quantity
*
0 lbs
55 lbs
110 lbs
OR Canada Malting Co. Red Wheat Malt
CM-RWHT Quantity
*
0 lbs
55 lbs
110 lbs
3. Great Western Malting Dextra Pils® Malt
GW-DEXT Quantity
*
0 lbs
55 lbs
110 lbs
4. Canada Malting Co. Flaked Oats
CM-FBOT Quantity
*
0 lbs
50 lbs
100 lbs
5. AB Biotek Pinnacle English Ale
AB-PHEA (by 500g brick)
*
No
Heritage English Ale, 1 brick
Heritage English Ale, 2 bricks
Heritage English Ale, 3 bricks
Additional Information
Does the malt you selected need to be milled?
*
Yes
No
If YES, which specs do you need your malt milled to?
1.0
1.6
1.8
2.0
2.2
How would you like to receive your product?
*
Shipment/Delivery
Will-call
Would you like your sales rep to contact you about adding additional (non-donated) products to your order to maximize your pallet?
*
Yes
No