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TODAY'S
DATE: 11/21/2009
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SEMEN OWNER INFORMATION
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* OWNER FIRST NAME:
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* OWNER LAST NAME:
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* OWNER ADDRESS 1:
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OWNER ADDRESS 2:
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* OWNER CITY:
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* OWNER STATE/PROVINCE:
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* OWNER ZIP/POSTAL CODE:
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* OWNER COUNTRY:
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* OWNER TELEPHONE:
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OWNER FAX:
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* OWNER EMAIL:
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STUD INFORMATION
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* REGISTRATION NUMBER:
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(If not registered, enter "None")
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* DOG'S FORMAL NAME:
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* DOG'S CALL NAME:
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* DOG BREED:
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CHOOSE
ONE
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BITCH OWNER
NEW
SEMEN OWNER
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* FIRST NAME:
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* LAST NAME:
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COMPANY NAME:
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* ADDRESS 1:
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ADDRESS 2:
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* CITY:
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* STATE/PROVINCE:
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* ZIP/POSTAL CODE:
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* COUNTRY:
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* TELEPHONE:
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FAX:
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* EMAIL:
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INSEMINATING
VETERINARIAN OR STORAGE FACILITY INFORMATION
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* FIRST NAME:
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* LAST NAME:
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* HOSPITAL/FACILITY NAME:
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* ADDRESS 1:
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ADDRESS 2:
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* CITY:
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* STATE/PROVINCE:
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* ZIP/POSTAL CODE:
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* COUNTRY:
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* TELEPHONE:
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* FAX:
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* EMAIL:
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REQUESTED
SHIPPING DATE (MM/DD/YYYY)
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SHIPPING AND METHOD OF PAYMENT
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PLAN
AHEAD!
CANINE CRYOBANK HANDLING CHARGES:
FOR SAME-DAY SHIPPING: $300
2-DAY SHIPPING: $200
3-DAYS OR MORE NOTICE: $100
Special Arrangements: TBD (minimum $375)
Please note that shipping charges are not included
in the handling fees listed above, and will be billed directly to
the FedEx number provided. |
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SHIPPING
COST INFORMATION: FEDERAL
EXPRESS OVERNIGHT,
28 POUNDS.
CALL 1-800-GoFedEx
FOR COSTS.
BE PREPARED TO GIVE THEM THE DESTINATION ZIP
CODE AND 92069 FOR SHIPPING COST COMPUTATION.
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SPECIAL INSTRUCTIONS:
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