In the space below, please list three choices for your reserved Breeder Identifier. If possible, your first choice will be reserved for you. Please include your payment of $50.00 with your request and send to the address below.
Today's Data (mm/dd/yyyy)
1st Choice: 2nd Choice: 3rd Choice:
Owner Code: Owner Name:
Signature
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Enclose $50.00 for your Breeder Identifier and mail to:
ILR PO Box 8 Kalispell, MT 59903