SAHPA SIRES CLASSIC BREEDER NOMINATION SHEET

                (for use by Interstate Breeders)

Breeder Name:           ____________________________________________

            Address:          ___________________________________________

                                    ___________________________Post Code _______

            Phone:        ____________________________________________

            Club:               ____________________________________________

Ring Number & Colour Markings

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Interstate Breeders Entry Fee                                                          $25

(Flat fee)

Attention:        Gavin Harris

                        488 Marion Road

                        Plympton Park  SA  5038

            Mob : 0418 853 111