C.E.R.F. EYE CLINIC

8-25-2005 --

C.E.R.F. EYE CHECK CLINIC

Sponsored by Greater Lafayette Kennel Club, Inc.

SATURDAY, SEPTEMBER 17, 2005

Conducted by Board Certified Opthalmologist,

Dr. S. Krohne, School of Veterinary Medicine, Purdue University.

The Clinic will be held on the Show Grounds with the cost of each exam being $25.00 (or $23.00 for pre-registration).

Dogs will be seen on a first come-first served basis on Saturday, 9:00 a.m. - 4:00 p.m.

Dogs must be present 20 minutes before examination to receive eye drops.

Pre-registration is encouraged.

MAKE CHECKS PAYABLE TO

GREATER LAFAYETTE KENNEL CLUB, INC. AND

MAIL TO: Edith Kline, 916 Elm Drive, West Lafayette, IN 47906

765-463-5635 email: edithkline@earthlink.net

PRE-REGISTRATION FEES AND FORMS MUST

BE RECEIVED BY AUGUST 31, 2005.

OWNER'S NAME _________________________________

ADDRESS _______________________________________

City _____________________________________________

State _________

Zip ____________________

PHONE___________________

EMAIL: __________________________

DOG'S REGISTERED NAME __________________________

DOG'S CALL NAME __________________________

BREED/VARIETY __________________________

COLOR SEX__________

BIRTHDATE AKC#______________________________

TATTOO/MICROCHIP # _________________________