2010/11 BOOKING FORM
for the stallion:
To secure your booking, complete both pages of this form and return with payment to:
AEA Burong, 675 Falloons Rd Woodend, Victoria 3442 ph 0417-527710/0354274400
SHIPPED SEMEN
Chilled
Service Fee
$
Overnight Courier Service
$275
Australia Post (Woodend)
Collection from Stud
$150
$110
Subtotal
$…..…..
Frozen
Service Fee
$…..…..
Shipper Usage Fee
$110
Insemination dose each $275 $…..….. (x…… doses)
Subtotal
AT STUD SERVICE
$……..
Chilled and Fresh A.I.
Service Fee (=total fee)
$…..…..
Frozen A.I.
Service Fee
$…..…..
Insemination dose each $275 $…..….. (x…… doses)
Scanning & AI each $275
$…..…..
TOTAL FEE
$…..…..
Enclosed
All prices quoted are GST inclusive
OWNER/BREEDER
ADDRESS
POSTCODE
Phone:
STATE: _________E-mail: ________________________
Fax:
Mobile:
I have read the terms and conditions and I agree to pay all fees, including all veterinary-, insemination- and
agistment costs as charged by AEA Burong.
SIGNATURE
DATE ____/____/2010/11
VET SURGEON
ADDRESS
POSTCODE
STATE:
Phone:
_________E-mail: ________________________
Fax:
Mobile:
Description of the Mare:
Name of Mare
Booked to:
Registered with:
Colour:
Freeze/Brand/Mark/ microchip
Age:
Height
Breeding
Sire:
Dam:
The mare is:
Dam’s Sire:
In Foal
Due to foal (date):
Empty
Sire of foal:
Maiden
Slipped
Missed last season
Complete the diagrams below with all brands and markings

Payment can be made by:
 Cheque or Cash
Direct deposit into the AEA Burong account with Rabobank Sydney
BSB 142 001 Account: 1216158-00