United Coloured Nomination Form

www.unitedcolouredstud.com

I ……………………………………………agree to take a nomination to the stallion

Sempers Spirit {delete as appropriate}

Name of mare …………………………….……Colour………………

Sire……………………………………………..Colour……………….

Dam……………………….……………………Colour………………

Breed …………………………………………..DOB………………..

Stud Book No…………….

Mares history {foals/competition results}

…………………………………………………..

Please include a copy of the mares breeding papers with this form and a clear current photo from the side.

Name of owner……………………………………….

Address ……………………………………………………………………………..

………………………………………………………………………………………

……………………………………………postcode……………………………….

Tel no……………………………………..

Email……………………………………..

Please state name and address of vets, who will be inseminating the mare

……………………………………………………………………………………

…………………………………………………………………………………….

……………………………………………………………………………………..

Please state name and address to where the semen should be sent if different from above

……………………………………………………………………………………..

…………………………………………………………………………………….

……………………………………………………………………………………..

Do you require?

Frozen semen

Chilled Semen

Do not send in nomination form without full payment, cheques made payable to

A. Chapman, no Semen will be sent until all cheques have cleared.

I have read and understood all terms and conditions offered by United Coloured Stud

Signature………………………….