Year Foaled:

Sire of Mare:

Sire of Dam:

Home Phone:

Fax:

Cell Phone:

Address:

Is this going to be an embryo transfer mare? Yes No
Last Date Bred:

Was Mare bred in 2007? Yes No		If so, to what stallion?
Was foal by embryo transfer? Yes No		Result: In Foal Barren
Was Mare bred in 2006? Yes No		If so, to what stallion?
Was foal by embryo transfer? Yes No		Result: In Foal Barren
Was Mare bred in 2005? Yes No		If so, to what stallion?
Was foal by embryo transfer? Yes No		Result: In Foal Barren

Give any particulars of any known breeding or foaling problems:

THIS IS NOT A CONTRACT
(Upon Approval of mare – Your breeding contract will follow)