Scrapie Ear Tag Order Form

Yes

Scrapie Flock Number:

No

I don't know

*Flock Owner

*Address

*City

*State

*Zip Code

*Email

*Phone

Check this box if your farm address is the same as your contact address

Farm Name

*Farm Address

*City

*State

*Zip

*County

Township

Range

Section

Yes

No

Average number of breeding animals:

Primary breeds or breed mixes:

Type of operation:

Raises/sells breeding stock

Commercial stock (market/feeders, hobby, 4H)

Do you have registered goats?

Yes

No

* Which kind of tags would you like to order?

(Plastic tags from Premier 1 Supplies are no longer available for reorder. Producers may continue to use these tags.)

Metal Tags - Hasco Tag Company (shipped in groups of 100)

Plastic Tags - Allfex USA, Inc. (shipped in groups of 20)

How many tags do you need for 1 year supply?

Do you need a tag applicator?

Yes

No

Additional comments: