Order Form

Purchaser Name   ____________________________________________________________

AGA Membership Number__________________     AGA Herd Prefix____________________

Shipping Address ____________________________________________________________

Email   ______________________________    Phone _______________________________

List below all other membership names and numbers to be included in initial herd extract:

• Please include all family and partnership accounts below - additional extracts requested later cost $50.

1.______________|_______________|_______________|______________|_____________

• Please list herds other than family or partnership accounts below -  written permission of owner and payment of $50 required for each extract.

2.______________|_______________|_______________|______________|_____________

$       350.00     Gelbvieh HerdTrack v.1.5.1 CD Software and initial herd extract on floppy disk
$ ________         Additional herd extracts from line 2 above (# _____@ $50.00* each)
$        10.00        Shipping & Handling
$ ________         Colo. residents add 3.70 % sales tax

$ _____.___         Total Amount Enclosed 

Credit card number__________________________________     expires ________________

Name (as it appears on credit card)______________________________________________

Credit Card Billing Address_____________________________________________________
___________________________________________________________________________

Please submit this form and your payment to:
American Gelbvieh Association, 10900 Dover St., Westminster, CO   80021
 303.465.2333  Fax:  303.465.2339  Email:  herdtrack@gelbvieh.org