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Winter Trophy Payment Confirmation Form
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Email *
Performer Name *
Please enter your First and Last Name below. This will be the middle line on your personalized trophy inscription, so please make sure there are no spelling errors. Additionally, make sure your name does not exceed 25 characters in length.
Performer Age *
Street Address *
Please enter a valid physical address in the United States where you would like us to ship your trophy below. Make sure to double-check that the address is 100% accurate, as we are unable to resend trophies due to address errors.
Apartment Number
If you live in an apartment, please enter your apartment number below.
City *
State *
ZIP Code *
Trophy Type *
Order # *
Please type your Order # below as proof of payment.
Date of Payment *
MM
/
DD
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YYYY
Payer's Name *
Payer's Email Address *
Parent/Legal Guardian's Name
If the finalist is under 18 years of age, their parent or legal guardian must complete this form on behalf of the finalist.
Parent/Legal Guardian's Email Address
If you are over 18 years of age, you do not need to complete this step.
Date of Form Submission *
MM
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DD
/
YYYY
Consent *
By checking the box below, you verify that the information provided above is true, you agree that address errors are not a valid reason for a trophy replacement/refund, and you understand that you must email us within 1 week of the delivery date in the unlikely event that you receive a trophy with defects.
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This form was created inside of Charleston International Music Competition. Report Abuse