Purebred Arabian
Five-Generation Pedigree
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Request Form
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Name of Horse(s): ______________________________________________________________________
 
Name:  _________________________________________________________________________
 
Address:  _____________________________________________________________________
 
___________________________________________________________________________________
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Postal Code: __________________________________________________________________
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Member Fee: $15.00 plus $0.90 gst = $15.90
Non-Member Fee: $25.00 plus 1.50 gst = $26.50

Please enclose payment.
Allow 4-6 weeks for arrival
 
_____ Certified Cheque or Money Order Enclosed
(Please Note: Personal Cheques are no longer accepted)
_____ Please charge the amount circled to my VISA or MASTERCARD.
 
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Expiry Date: ____________________________________________________place17high.gif (70 bytes)
MASTERCARD #: ____________________________________________________place17high.gif (70 bytes)
Expiry Date: ____________________________________________________place17high.gif (70 bytes)

Signature		 ____________________________________________________