Name of Mare:___________________________________________

Mare Owner's Name:_____________________________________

Shipping Address:________________________________________

(No P.O. Box , Must be Street Address or Rural Route)

Person Receiving Shipment:________________________________

Phone Number + Area Code:_______________________________

Fax Number + Area Code:_________________________________

Unless otherwise specified, UPS Overnight Delivery will be used to deliver semen shipments. If you have your own UPS account and wish to be billed directly, fill in the following:

UPS Account #:________________________________________

Account Name:___________________________________________

If you do desire an alternate method of shipment please specify it below and furnish any additional information that would be useful in serving your delivery needs ( i.e., nearest airport, etc.).

Requested Alternate Method:_______________________________

Additional Information:____________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

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