If you would like to place an order for a Gloucester Old Spot, or any other breed (more info at the bottom of this form), you can do so by e-mail, fax, post or telephone.
Please fill out the form below and either send it via e-mail or fax, or print it and post it back to me.

YOUR DETAILS:

Name:
Telephone:
Fax:
Email:
Address
Address 2
Address 3
Post code / Zip
Country
Delivery Address if different
PIG/S REQUIRED:
Gloucester Old Spot Male Breed Lines	Gloucester Old Spot Female Breed Lines
(Please select the number you require of each type)
Gerald 0 1 2 3 4 5 6 7 8 Patrick 0 1 2 3 4 5 6 7 8 Rufus 0 1 2 3 4 5 6 7 8 Sambo 0 1 2 3 4 5 6 7 8     Different Breeds / Breed Lines required. Enter free text details in box below: (Further info at bottom of this form) .	Blue Bell 0 1 2 3 4 5 6 7 8 Countess 0 1 2 3 4 5 6 7 8 Dahlia 0 1 2 3 4 5 6 7 8 Dolly 0 1 2 3 4 5 6 7 8 Ellen 0 1 2 3 4 5 6 7 8 Josephine 0 1 2 3 4 5 6 7 8 Muriel 0 1 2 3 4 5 6 7 8 Primrose 0 1 2 3 4 5 6 7 8 Princess 0 1 2 3 4 5 6 7 8 Princess Ann 0 1 2 3 4 5 6 7 8 Princess Freda 0 1 2 3 4 5 6 7 8 Princess Joan 0 1 2 3 4 5 6 7 8 Princess mary 0 1 2 3 4 5 6 7 8 Star 0 1 2 3 4 5 6 7 8 Star Antionette 0 1 2 3 4 5 6 7 8
Age	7 Weeks - 12 Weeks 12 Weeks - 24 Weeks 24 Weeks - 52 Weeks Older than 52 Weeks
Blood test req	Yes No
If yes, type of test req	Blue Ear (english strain) Blue Ear (american strain) Aujeskies T.G.E. T.B. Swine disease Leptrosprosis Rhineitus Interitus All Other (please state below)
Tests required other than list
Ship by date
Preferred transportation	Road Road & Sea Road & Air
Payment method	Cheque B.A.C.'s transfer Bank letter of gaurantee Credit card by telephone Credit card by post
Payment method details

Ordering other breed lines / other breeds.

If there is a breed line, or other breed you require that we do not have in our herd, we will source the line where possible and bring it into our isolation pens for you until shipment, so that all blood tests can be done together and all livestock can travel together.

Complete service.

We aim to offer a quality service - the pigs you require, when you require them!
If there is anything else you would like in the way of information or assistance, then please don't hesitate to contact me by any of the means stated at the top of this form.