Items Ordered:

 Customer Information:

First Name:             Last Name:

Home Address:

City/Province:   State:

Zip/Post Code:                  *Country:

Phone Number:           Fax:

E-mail Address:

* NOTE: If your country is not on the list - we don't ship there!

Comments / Instructions / Additional Addresses:

Print this order and mail with check to:

Bash Dibra
c/o Fieldston Pets
3476 Bailey Avenue
Riverdale, New York 10463

Credit card orders, please call:

(718) 796-4541

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