First Name: Last Name:

Home Address: City: State:

Primary Phone:

3185 Hamner Ave. Norco, California 92860-1937 1-800-336-2843 Fax: 951-737-8967

Zip:

Pet's Name: Microchip #:

AVID 3185 Hamner Avenue Norco, CA 92860-1937

The microchip number can be located on your pets blue collar tag. If the collar tag is missing or unreadable you can find the chip number on your microchip certificate or documentation you received from your veterinarian.

Credit Card #:

Expiration Date: Security Code:

Signature on Card:

Payment Information

Replacement tags can be paid with a credit card, personal check or money order.

Choose Payment Method: If paying by check or money order you must mail in this form with your check or money order and make payable to AVID.

Mail check to:

PETtrac Stainless/Brass Tag Order Form

Contact Information

Pet Information

Date:

Tag Information

Brass Tag $13.95Choose your Tag: Stainless Steel Tag $11.95 Personalized Stainless Steel Tag $18.95

Choose your Size: Large Tags (1" diameter) Small Tags (3/4" diameter)Ideal for medium to large dogs Perfect for your cat or small dog

Enter your custom text below to customize the tag label.

1st Custom Line:

2nd Custom Line:

3rd Custom Line:

Allow 3 lines with 16 characters per line for large collar tags.

Allow 2 lines with 14 characters per line for small collar tags.

Fill-out this section if you selected Personalized Stainless Steel Tag from above.

Prices are subject to change without prior notice

Solid Brass Tag

Stainless Steel Tag