DOGenes Renal Dysplasia Testing Order Form

Breed	Category	Price	Quantity	SUB-TOTAL
Boxers	n/a	$155.00	____	__________
10+ Boxers*	n/a	$99.00/ea	____	__________
Cairn terrier	n/a	$125.00	____	__________
10+ Cairn terriers*	n/a	$99.00/ea	____	__________
English Cocker spaniels	n/a	$75.00**	____	__________
Golden retreivers	n/a	$155.00	____	__________
10 +Golden retreivers	n/a	$99.00/ea	____	__________
Lhasa Apso	ALAC Member	$70.00	____	__________
	non-ALAC Member	$82.50	____	__________
Miniature Schnauzer	AMSC Member	$70.00	____	__________
	non-AMSC member	$82.50	____	__________
Shih Tzu	ASTC member	$70.00	____	__________
	non-ASTC member	$82.50	____	__________
Poodles	n/a	$155.00	____	__________
10 +Poodles	n/a	$99.00/ea	____	__________
Soft Coated Wheaten Terriers	n/a	$155.00	____	__________
10 +Soft Coated Wheaten Terriers	n/a	$99.00/ea
Weimariners	n/a	$75.00**
MAIL ORDER DISCOUNT		$5.00	__1____	$5.00
			SUBTOTAL	__________

TAX
	residents of AB,BC,MB,,NT, NU,QC,SK	Add 5%		_____________
	residents of ON,NL, NS, NB or PE	Add 13%		_____________
			TOTAL	_____________

**Price for Jan. -Feb., 2008 only

PRICES ARE IN CANADIAN DOLLARS There is a $35.00 service charge (CDN) for returned checks.

Mail this form to :

DOGenes Inc., 161 Sherin Ave., Peterborough, ON, K9J 7V5, CANADA

Send kits to:

Name:__________________________

Address:__________________________________________________________

Phone No.______________

e-mail______________________