Frozen Semen Report – Welsh Pony & Cob Society of America

We offer two ways to submit WPCSA forms. You may either print a hard copy and snail mail by choosing the “print and mail form” button or use the on-line form below to submit your form. If payment is required the on-line form allows for payment with a credit card. If you choose this option, please make sure you receive a confirmation of receipt email.

Print and Mail Form

On-Line Form

PLEASE USE THIS FORM TO REPORT SEMEN WHEN IT IS FROZEN AND TO TRANSFER FROZEN SEMEN TO A NEW OWNER.

"*" indicates required fields

Stallion Name*

Stallion Registration #*

AI Permit # (if known)

Date Frozen

Number of Straws/Doses

Storage Location of Straws

Name of New Owner if transferring

First Last

Please provide the name of the new owner.

Date Transferred to New Owner

Number of Transferred Straws/Doses

Storage Location of Transferred Straws/Doses

Address of New Owner

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email of Selling/Freezing Owner*

Signature of Selling Owner*

By typing your name above you are signing your name to the transfer of the owner name listed on the AI permit of the above listed stallion.

Transfer of Semen

Price: $30.00

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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