| Jodie Keener JBK LLC Boarding Form Date:_______________ Client Name: ________________________________________________________________________ Address: ___________________________________________________________________________ Home Phone: ___________________________ Work Phone:_________________________________ Cell Phone: _________________________________________________________________________ Email address: ______________________________________________________________________ Emergency Contact___________________________________________________________________ Charges Board $20.00 daily Long Term Board $400.00 monthly Boarding and Conditioning $25.00 daily Boarding and Conditioning $500.00 monthly Flea Preventative $10.00 month unless provided by owner Heartworm Preventative $10.00 month unless provided by owner Agent #: 6388 cell: 817-313-1116 email: jbkaussies@yahoo.com Address: P.O. Box 378 Joshua, Texas 76058 www.jbkworldchampions.com Jodie Keener JBK All Breed Handler LLC 2/10/2010 |