DOGenes Renal Dysplasia Testing Order Form

INTERNATIONAL ORDERS

Breed	Category	Price	Quantity	SUB-TOTAL
Lhasa Apso	ALAC Member	$65.00	____	__________
	non-ALAC Member	$80.00	____	__________
Miniature Schnauzer	AMSC Member	$65.00	____	__________
	non-AMSC member	$80.00	____	__________
Shih Tzu	ASTC member	$65.00	____	__________
	non-ASTC member	$80.00	____	__________
Boxer	n/a	$150.00	____	__________
Poodle	n/a	$150.00	____	__________
Soft Coated Wheaten Terrier	n/a	$150.00	____	__________
MAIL ORDER DISCOUNT		$5.00	__1____	$5.00
			TOTAL	__________

PRICES ARE LISTED IN US DOLLARS. There is a $35.00 service charge for returned checks

CANADIAN ORDERS

Breed	Catergory	Price	Quantity	SUB-TOTAL
Lhasa Apso	ALAC Member	$70.00	______	_____________
	non-ALAC Member	$87.00	______	_____________
Miniature Schnauzer	AMSC Member	$70.00	______	_____________
	non-AMSC member	$87.00	______	_____________
Shih Tzu	ASTC member	$70.00	______	_____________
	non-ASTC member	$87.00	______	_____________
Boxer	n/a	$105.00	______	_____________
Poodle	n/a	$105.00	______	_____________
Soft Coated Wheaten Terrier	n/a	$105.00	______	_____________
MAIL ORDER DISCOUNT		$6.00	__1____	__$6.00____
TAX
	residents of AB,BC,NT, NU,QC,SK	Add 6%		_____________
	residents of ON,NL, NS, NB or PE	Add 14%		_____________
			TOTAL	_____________

PRICES ARE IN CANADIAN DOLLAR AND ARE SUBJECT TO CHANGE BASED ON EXCHANGE RATE WITH US DOLLAR. There is a $35.00 service charge (CDN) for returned checks.