(Please print out, fill out, and either mail or fax with your personal check or money order payment)

*If you chose to e-mail your request, please send an email to info@canineangelsinc.com with all of the following information included*

ORDER FORM

"CANINE ELBOW PROTECTIVE SLEEVE"

QUANTITY:_______ x $58.00 + Shipping and handling

NAME:___________________________________________________________

STREET ADDRESS:_________________________________________________

CITY:_______________________STATE:___________ZIP:_________________

PHONE NUMBER:_________________________________________________

BREED:___________________________DOG'S WEIGHT:_________________

DOG'S NAME:__________________________________________AGE:______

NOTES:__________________________________________________________

________________________________________________________________

IF VETERINARIAN'S OFFICE, PLEASE FILL OUT THE FOLLOWING:

 VET OFFICE:__________________________CITY/STATE:________________

VETERINARIAN'S NAME:__________________________________________

TAX ID NUMBER:_________________________________________________

The Canine Elbow Protective Sleeve is shipped via UPS Ground. Please contact Canine Angels, Inc. at (248) 693 0021 or by fax at (248) 693 0358 for pricing and shipping on quantity orders, or any questions regarding this product.