Millennium Farms -- SEASON REQUEST

To request a season with a Millennium stallion please complete the form below.

This form must be on file prior to mare being booked. Thank you for your assistance.

STALLION INFORMATION

Stallion
Share # and/or Agent	Please note: If you purchased a season to this stallion thorough a Shareholder or an agent, please list the number of the Share's season purchased and/or the agent's name

OWNER INFORMATION

Name of Mare Owner
(Please indicate the Name of Owner in the way you wish it reported to the Jockey Club)
Address
City
State
Zip or Postal Code
Country
Telephone Number
Fax Number
Email

MARE INFORMATION

Mare Name

Year of Birth

Color

Sire

Dam

Dam's Sire

Mare's Current Status

In Foal Barren Maiden Slipped/Aborted Not Bred

Mare's 2010 Produce
(if applicable)

Foaling Date
Sex	Colt Filly
Color
Stallion Bred to in 2009
Last Date Covered in 2009

Is This Mare an IMP0RT for the 2010 Breeding Season? Yes No

Import Date
Country of Origin

2010 Boarding Farm

Farm Phone

Farm Manager/Contact

Mare's Recent Produce History

Year Foaled	Sire of Foal	Date Foaled	Foal Color	Foal Sex
2009				Colt Filly
2008				Colt Filly
2007				Colt Filly

COMMENTS

Please list any information relating to status, condition, or disposition of your mare that you feel is important for the breeding shed to have on file