Client Payment Form

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Breed Control Order

Please fill this form in order to order a breed control examination

Email *

Full Name *

Address *

City *

Phone *

Litter Date of birth *

Mother Name *

Breeding No. of the father *

Father Name

Breeding No. of the father

Number of males born *

Number of females born *

Club Membership *

I'm a club member
I'm not a club member (450₪)

agree *

I aware that puppies needs to have microchip and first vaccination

DNA Tests

The parents has DNA health results (200₪)
The parents does not health results (200₪)

Payment method

CREDIT_CARD

Total: 0₪