Cordelia Kennels Booking Form

PLEASE NOTE:
When booking on line the booking is only tentative until you receive written confirmation from us that your booking and dates requested are available.

Please note * = required

Full Name * Enter your full name,
Email * Enter a valid email address.
Phone * Enter a valid phone number
Address *
Period Required*
1. From
2. To
Dogs Name
Age
Breed
Is your dog desexed?
1. Yes
2. No
Please note that we only take females in season by prior arrangement
Medication: *
Comments
DO NOT FILL IN THIS FIELD!!
Valid Information? *
1. Yes
2. No
Do you agree that the information you have provided is valid and is not spam?

Bank Details for Direct Deposit
Bank:	NAB
Account Name:	Cordelia Pet Care Centre
BSB:	084-970
Account Number:	871 650 113
Reference:	Please use first name of pet and your surname eg. Buster Smith

Please put the above reference on if either paying direct at a branch or over the internet so that we can match the deposit to your pet's guest card.