Requested Date of Chilled Semen Collection

MM

DD

YYYY

Mare Owner’s Name

First Name

Last Name

Mare Owners Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mare Owners Phone

(###)

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Veterinarian’s Phone

(###)

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Collection Fees:

Shipper Rental: Shipper must be returned within 10 days or you will be charged a late fee. PLEASE TICK

Collection Fee: $275.00 GST Inclusive

Shipper Rental: $33.00 GST Inclusive

Shipping Information: (Please Tick)

Every effort will be made to ensure that The chilled semen arrives in the best possible condition and at the agreed time as stated by the freight company. However, we are powerless if the freight company loses the semen or fails to deliver to the agreed place. We accept no responsibility for such loses & reserve the right to charge repeat collection fees & freight fees if required. Negotiations between the mare owners & the freight company will not be our responsibility in such cases. • *PRICE DEPENDS ON LOCATION

(Toll) Team Global Express Priority-Overnight *

Tamex*

Qantas Freight Priority-Airport to Airport- Guaranteed Next Flight*

Transport to Tamworth - $60 (only for Qantas or Tamex)

Phone: (if different from above):

(###)

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