DOGenes Renal Dysplasia Testing Order Form

INTERNATIONAL ORDERS

Breed	Category	Price/ea	Quantity	SUB-TOTAL
Boxers	n/a	$155.00	____	__________
10+ Boxers	n/a	$99.00	____	__________
Cairn terrier	n/a	$155.00	____	__________
10+ Cairn terriers	n/a	$99.00	____	__________
Collies	n/a	$155.00	____	__________
English Cocker spaniels	n/a	$155.00	____	__________
Golden retreivers	n/a	$155.00	____	__________
10 +Golden retreivers	n/a	$99.00	____	__________
Lhasa Apso	ALAC Member	$80.00	____	__________
	non-ALAC Member	$95.00	____	__________
	ALAC Member litters	$48.00	____	__________
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	____	__________
Portuguese Water Dogs	n/a	$155.00	____	__________
10+ Portuguese Water Dogs	n/a	99.00	____	__________
10 +Poodles	n/a	$99.00	____	__________
Shetland sheepdogs	n/a	$155.00	____	__________
Soft Coated Wheaten Terriers	n/a	$155.00	____	__________
10 +Soft Coated Wheaten Terriers	n/a	$99.00	____	___________
Tibetan Terriers	n/a	$155.00	____
10+ Tibetan Terriers	n/a	$99.00
Weimariners	n/a	$155.00
MAIL ORDER DISCOUNT		$5.00	__1____	$5.00
			TOTAL	__________

*Order 10 or more JRD tests and receive the discounted price of $99.00 per test.

PRICES ARE LISTED IN US DOLLARS. There is a $35.00 service charge 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______________________