NDM Clinic Organisation form

NDM Clinic Organisation formJames Taylor2023-04-21T15:50:55+10:00

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NDM Organisation Participation Form - 2023

"*" indicates required fields

Organisation Name*

Contact person*

First name Last name

Phone number*

Email*

Address*

Street Address Suburb State Post code Country

YES, WE WILL HELP BY:*

Offering the National Desexing Month Low Cost Desexing prices for cats and dogs.

Offering the National Desexing Month Low Cost Desexing prices for cats only.

Offering our own Special deal the month of July

* Please select and complete the relevant boxes to confirm your offer in July.

CAT PRICES

Prices for cats*

Enter Price here Enter Price here

DOG PRICES

Prices for small dog (1kg - 10kg)*

Enter Price here Enter Price here

Prices for medium sized dog (11kg - 25kg)*

Enter Price here Enter Price here

Prices for large dog (26kg - 40kg)*

Enter Price here Enter Price here

Prices for Extra large dog (41kg+)*

Enter Price here Enter Price here

CAT PRICES

Prices for Cats*

Enter Price here Enter Price here

RABBIT PRICES

Please specify if applicable

Prices for Rabbits*

Enter Price here Enter Price here

AND OFFER THIS TO:*

Please specify

General Public

Pension/concession cardholders only

Other

Please explain if anyone else is eligible

How can the public access your NDM offer?

Email

Phone

Website

WE WOULD LIKE TO RECEIVE NDM PROMOTIONAL MATERIAL*

Please specify

Yes

No

IMPORTANT:

During National Desexing Month clients do not require NDN vouchers for desexing. Clients are to book directly with you and not through NDN. No vouchers will be issued by NDN for this campaign.