EYE CLINIC

                        Sponsored by the Samoyed Fanciers of Central Fla, Inc

            When:  8AM-5PM, Sat. Dec. 16, 2006

            Where: Craft Building, Central Florida Fairgrounds, Orlando, Fla.

            Dr. Kathleen P Barrie, DVM, DACVO

            Cost:  $32/per dog

            Reservation preferred but walk-ins accepted.  Reservations due at

            address below by Dec. 13th.

            Make checks payable to: Samoyed Fanciers of Central Fla

            Mail checks with reservation form(s) to:

             Karyn Kramer, SFCF Corr. Sect'y

            PO Box 466

            Lithia, Fla. 33547

            For additional information contact:  Laura Segers, (813) 685-0121

       email: [email protected]

            Reservation Form

            (One entry form per dog, copies of this form may be made for multiple

            dogs)

Dog's Registered Name_________________________________________

Dog's AKC # _______________Dog's Sex_____Date of Birth___________

Owners Name_________________________________________________

Owner's Address ______________________________________________

                              ______________________________________________

Owner's Phone #___________________ Email:_______________________

Preferred Reservation time:  ____AM    _____PM  (Owners will be notified

of reservation times either by email or phone ) 

Amount enclosed: ____________