ARTIFICIAL INSEMINATION VIDEO/KITS ORDER FORM
 Fill out information, right mouse click on form, select "Print", then fax to 760.591.9939

Name of Product: If choosing more than one product, please use separate forms.
 Qty:
TODAY'S DATE:
 
Note: Shipping charges (except on AI DVD to US/Canada) and taxes will be added.
CONTACT INFORMATION
NAME
 TELEPHONE FAX
STREET ADDRESS
 E-MAIL ADDRESS
CITY/PROVINCE
 STATE ZIP COUNTRY
SHIPPING INFORMATION
SAME AS ABOVE
ADDRESS
  
CITY/PROVINCE
 STATE ZIP COUNTRY
METHOD OF PAYMENT
USE OTHER SHIPPER/PAY ARRANGEMENTS

ACCT. #
Call 1 800 GoFedEx for an account #
PAYMENT METHOD
MONEY ORDER CHECK USE FedEx AND PUT ON VISA/MC
VISA/MC NUMBER
EXP. DATE
FedEx A.W.B. #
 Use the FedEx AirWayBill # to track shipment.
SEND CHECK OR MONEY ORDER TO: CANINE CRYOBANK, 120 N. PACIFIC A5, SAN MARCOS, CA 92069
DATE SENT