American Miniature Zebu Association P O Box 2095 Lady Lake, FL 32158 Phone: (352) 391-0977 amzaregistrar@gmail.com Online Semen Donor/AI Sire Form Sire (including Herd Name): AMZA #: Owner of Sire: Street Address (required) City (required) State (required) Zip Code (required) Email (required) Home Phone Cell Phone Collection Facility and Location: Name of Technician or Veterinarian: Tech or Veterinarian Phone: Storage Facility and Location: Number of Straws Provided: Notes: Dam (including Herd Name): Owner of Dam: AMZA #: Street Address (required) City (required) State (required) Zip Code (required) Email (required) Home Phone Cell Phone AI Service Dates: Number of Straws used per cow: Please read and check mark: I/we certify the above is a true and correct statement/representation. I/we desire to have the same recorded in the American Miniature Zebu Association registry. I/we understand that by knowingly falsifying any above information will result in the disqualification of this Zebu. I/we also understand that membership with AMZA will be revoked. There will be no refunds made for neither registrations nor membership. Yes Date:
