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Date of Clinic:
Name of Sponsoring Organization/Club:
Location, including city, state, zip:
All Breed Clinic?
If Single or Selected breeds, list:
List Tests below (one per line; test: physician, cost):
Is Pre-registration required?
If yes, list pre-registration date:
Details and contact information for those wanting to register for the clnic:
Approximate number of dogs expected at the clinic:
Number of discount labels requested:
Your name (name of person submitting clinic:
Your email address:
Snail Mail Address to send labels to (name, street address, city, state, zip):