Sample

Reservation Form

NOTE: PLEASE make sure that your Breeder knows to have your Pet (if over 12 weeks old)equipped with a FITTED HARNESS at time of pickup.

E-mail Address: *
CUSTOMER/RECIEVER NAME *

RECIEVER PHONES WITH AREA CODE-Please provide at least 2 contact numbers *

RECIEVING ADDRESS-Please include FULL address with zip *

SHIPPER NAME *

SHIP FROM ADDRESS-Please include FULL address with zip *

SHIPPERS PHONE & AREA CODE- Please provide 2 contact numbers *

REQUESTED TRANSPORT DATE *

COMMENTS

PETS NAME

BREED & GENDER *

COLOR & MARKINGS *

APPROXIMATE WEIGHT *

What size crate will your pet need? Please visit our Transport Costs page to determine the proper size crate. *

SPECIAL REQUESTS

I HAVE READ & AGREE WITH THE TERMS OF GET-M-HOME TRANSPORT AGREEMENT *
YES NO
IN THE EVENT THAT THE ABOVE DESCRIBED PET SHOULD BECOME ILL, I AUTHORIZE GET-M-HOME TO SEEK & PROVIDE VET TREATMENT AS NECCESSARY *
YES NO
I UNDERSTAND THAT I AM RESPOSIBLE FOR ALL VET BILLS & MEDICATIONS REQUIRED TO TREAT MY PET DURING TRANSPORT, AND AGREE TO REIMBURSE ALL SUCH CHARGES *
YES NO
I, the reciever, understand that this form is a LEGAL CONTRACT & hereby agree to be bound by all herein upon submission of this form. *
YES NO

Verification Code:
Enter Verification Code: *


* Required

Close This Window

Site Design by Awesomewebdesign.net

Close This Window