W.H.S.A.

Office use only Date received: SBK signature:

The Waler Horse Society of Australia Inc. ARBN 088 999 624 Organisation No.: A0016480F

STALLION SERVICE RECORD Please read carefully & fill in all questions

Waler stallion service record for the breeding year: Owner/lessor name: Postal Address: Telephone: Mobile: E-mail: Web: Location/address of stallion (if different from above): Address:

Member No: Postcode:

State: Fax: Tel.: State:

Postcode:

NAME AND DESCRIPTION OF STALLION Stallion name:

NO.

MARE NAME

Reg. no.:

BREED

REG. NO.

COLOUR, MARKINGS & BRANDS

SERVICE DATE

OWNER CONTACT DETAILS

1 2 3 4 5 6 7 8 9 10 Declaration: I/We attest that to the best of my/our knowledge, the information obtained herein is true and correct, and agree to abide by the WHSA Constitution and Horse Register Rules and Regulations as amended from time to time. Owner/lessor: Signature: Date:

Please return form to WHSA: PO Box 704, Tamworth, NSW 2340, OR [email protected] © Copyright 2017 The Waler Horse Society of Australia Inc. Stallion Service Record - Latest document update October 2017 Page 1 of 1