Order form

Stallion: *

Delivery date/Estimated date 1st insemination: *

Artificial insemination or Embryo transfer *

Customer/Owner data
VAT liable or not liable to VAT *

Name *

Company name

Street *
Postal code *
Residence *
Country *

VAT number *

Phone/Mobile number *
E-mail

Data mare to be inseminated
Name mare *
Chip number *
Studbook number (UELN no.)*
Date of birth *
Original pedigree (from passport) *

Billing address
Billing address *

Name *

Company name *

Street *
Postal code *
Residence *
Country *
Phone/Mobile number *

Delivery address
AI-centre *

Name veterinary:
Name AI-centre *
Street *
Postal code *
Residence *
Country *
Phone/Mobile number *
Name vet
Name AI-centre *
Street *
Postal code *
Residence *
Country *
Phone/Mobile number *



* = Required field


Our bank data

Sophie VAN CANTE
BNP Paribas Fortis
IBAN: BE63 0017 8422 8508
BIC: GEBABEBB