Please print this page and send it to us along with your check payment of $25.00.
Make checks payable to: Okaw Vet Clinic
Mail to:    Okaw Vet Clinic
               140 W. Sale St.
               Tuscola, IL   61953

     Yes! I want to sign up for the Animal Behavior Network

Date: ____________

Name: ____________________________________

Address: __________________________________

City: _____________________________________

State: _______ Zip Code: ___________________

Phone number: (_____)______________________

Email: ____________________________________

Pet's Name: _______________________________

Type of pet (Dog, Cat, Etc): _________________

Pet's age: ________________

Gender: _________________

Spayed or Neutered: __________________

Behavior concern: __________________________

_________________________________________

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