Download DNA Collection Veterinary Form10 December

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Transcript
TGCA DNA Profile Request Form
To be completed, signed and stamped by a Veterinary Surgeon
EQUINE DETAILS
Name:
Passport ULEN
Number:
Microchip Number:
VETERINARY SURGEON DETAILS
Name:
Telephone
No:
Address:
I certify that the above equine particulars are correct and that I have today collected a
hair sample from this equine for DNA profiling. I have sealed the collected hair into a
labelled bag and duly signed the label to certify that the sample is from the animal stated.
Date:
Signature:
Please place stamp here:
TGCA DNA Profile Request Form
www.tgca.co.uk
Page 1 of 2
HORSE OWNER DETAILS
Name:
Telephone
No:
Address:
Email:
TGCA
Membership
Number:
I authorise the TGCA to request a DNA profile for my above named horse in and to store
the result on their breed database. I understand and agree that the TGCA may use this
DNA data in their activities associated with the future development of the breed.
Date:
Signature:
Your DNA sample, this completed form and payment of £45 (members) or £50 (non
members) should be sent to:
TGCA, PO BOX 1120, CANTERBURY, CT1 9UL, UK
Please make cheques payable to TGCA Ltd. Cheques must have the bank card details on the
reverse side. If you are sending cash, please send it recorded delivery.
Upon completion the DNA profile results will be uploaded to the TGCA database. If you
make a specific request then the TGCA will email you with a copy of the results. Please note
that it may take up to three weeks for the laboratory to return your results to the TGCA.
For Office Use Only
TGCA Ref
TGCA DNA Profile Request Form
ID No
Date
Received
www.tgca.co.uk
Page 2 of 2