Leather Brow Band Order Form

1. Complete the order form below then click “Submit” to send your request to me (Leslie Raulin). 

2. Provide payment via check, PayPal Friends & Family, or cash (no credit cards as this is not a business):

• Check: Mail a check for the total amount, made out to Leslie Raulin, to:

                                Leslie Raulin
                                2027 Gapland Road
                                Jefferson, MD 21755     

• PayPal: Send the total amount via PayPal Friends and Family (contact me for instructions). Since this is not a commercial endeavor you must use PayPal “Friends and Family“
• Cash: If you pay at Blue Horse Farm or a show where the brow bands are displayed.  I do not have change.

I will then make your brow band, if needed, and mail it to you. 

3. If you want to see / select / design / pick up your brow band in Jefferson, MD:

• To see/select/design a brow band in Jefferson, MD: Email me at LeslieRaulin@gmail.com to set up a day/time.
• To pick up a brow band in Jefferson, MD:  I will email you to let you know the brow band is ready, then I will place your completed brow band in a blue box on the white porch on my house porch – 2027 Gapland Road, Jefferson, MD 21755.

4. If you want to see / select / pick up your brow band at a FADS @ Blue Horse Farm or a show where the brow bands are displayed, just come to the show.  Pay via check, cash (I do not have change), or PayPal Family.

5. I will send a check to the charity for the amount of your donation.  I usually send the donations on a quarterly basis.

Please complete the following form to order a leather brow band:

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Name *

First

Last

Bead (Select Number

Email *

Phone Number *

Street Address *

City, State, Zip Code *

Ready-Made Leather Brow Bands (if you select one of these, keep the next 3 choices blank)

• LEA-0001 – 15″ U-shaped with Red Small Sunburst Beads (delicate)
• LEA-0002 – 16″ U-shaped with 8mm Blue Faceted Flat Round Beads (less delicate)
• LEA-0003 – 17″ Straight with 8mm Green Faceted Beads (delicate)
• LEA-0004 – 16″ Straight with 8mm Light Blue Faceted Beads (delicate)
• LEA-0005 – 17″ Straight with Red, White & Blue Faceted Round Beads (delicate)

Standard Bead Design Number (for designs on website)

Custom Bead Design (bead size, bead colors, etc.)

1" Black Brow Band Size, Shape & Bead Size (Select One) (This is a list of items in stock; I will not be ordering more.)

• 14″ (pony) U-shaped for 8mm beads
• 15″ (cob) U-shaped for 10mm beads
• 16″ (horse) U-shaped for 8mm beads
• 16″ (horse) straight for 8mm beads
• 17″ (warmblood) U-shaped for 10mm beads
• 17″ (warmblood) straight for 10mm beads
• 17″ (warmblood) U-shaped for 8mm beads
• 17″ (warmblood) straight for 8mm beads

Charity to receive your donation (select one): *

• Frederick County 4-H Therapeutic Riding Program (https://www.fc4htrp.org/)
• Hurwitz Breast Cancer Fund (https://www.pinkribbonfrederick.org/)
• Owner-2-Owner (https://defhr.org/owner-listings/)
• Catoctin Chapter of PVDA (http://catoctinchapterpvda.weebly.com/)

How will you pay for your brow band? *

• Via check made out to Leslie Raulin
• Via PayPal Friends & Family (email LeslieRaulin@gmail.com for instructions)
• Cash at a show or Jefferson, MD (need exact amount as I will not have change)

How do you want to receive your brow band?

• Via snail Mail ($8.50, subject to change)
• Pick up in Jefferson, MD
• Pick up at a show where the brow bands are displayed

Comment or any other information you want to include. (optional)

Your Costs (select as many as apply) *

• REQUIRED Materials Cost – $35.00
• REQUIRED Donation – $30.00
• Additional Donation – $5.00
• Additional Donation – $10.00
• Additional Donation – $15.00
• Additional Donation – $20.00
• Additional Donation – $25.00
• Additional Donation – $30.00
• Additional Donation – $40.00
• Additional Donation – $50.00
• Postage & Handling – $8.50

Total (pay this amount)

$0.00

Submit