DNA Test Kit Request Form

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Request for DNA Test Kit
I would like to request a DNA Test Kit ($50.00) for:
Horse/Pony Name: *
Registration #:
Sire:
Dam:
Match Test

YES NO
Please mail DNA Test Kit to:
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Daytime Phone *

- Area Code Phone Number
Email *
example@example.com
FEE INCLUDES 3% ONLINE PROCESSING CHARGE
Payment *

DNA Test Kit $ 51.50

Total $ 0.00
American Hackney Horse Society
4059 Iron Works Parkway, A-3
Lexington, KY 40511-8462

(859) 255-8694 • ahhscsl@qx.net

www.hackneysociety.com
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