European Medications!Testing!Order!Form!
Date:!_______________________________!
Event
!Name:!__________________________________________________________________________!
Event!Address:!________________________________________________________________________!
City:!_________________________________________________________Zip:!____________________!
Country:!________________
_____________________Start!date!of!event:!________________________!
(Send!in!a!copy!of!the!show!schedule!with!this!form.)!
Show!Number(s):!______________________________________________________________________!
Number'of'expected'horses'at'event:!_______!
Number'of'NRHA'medication'tests needed'at'Event :!_______(=!number!of!horses!/!20)!!
Show!secretary:!______________________________________________ NRHA!ID:!
__________!
Phone:!___________________________________!Email!address:!______________________________!
Show!manager:!______________________________________________ NRHA!I
D:!__________!
Phone:!___________________________________!Email!address:!______________________________!
Invoice'information'for'testing:'
Legal!entity!or!individual!responsible!for!payment:!____________________________________!
Address:!_____________________________________________________________________________!
City:_________________________________________________________Zip:_____________________!
Country:!_____________________________________!
Phone:!___________________________________!Email!address:!______________________________!
Signature:!_________________________________________________!
Mail!this!form to euromedications@nrha.com no later than three (3) weeks before the start of the event.
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