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PET AIR
1527 GRAND BLVD. KANSAS CITY, MO 64108
(816) 471-3852 FAX (816) 842-7387
EMAIL flypetair@yahoo.com

SHIPPING CONTRACT MUST BE FILLED IN COMPLETELY Mouse over this graphic to pop up HELP for each field. You can also click here for PRINTABLE instructions.
Are you renewing an existing shipping contract?
NAME OF SHIPPER:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:	FAX:
ALT PHONE:
E-MAIL:
Password:
Comfirm Password:
Passwords must be 6 characters long.

SOCIAL SECURITY NUMBER:
DRIVER’S LICENSE NUMBER:
TYPE OF ANIMALS TO SHIP:
AIRPORTS SHIPPING FROM:

REFERENCES
Bank Name:
Address:
City:
State:	Zip:
Phone:	Fax:
Account #:
Contact Person:

Veterinarian Reference:
Address:
City:
State:	Zip:
Phone:	Fax:
Account #:
Contact Person:

Business Reference:
Address:
City:
State:	Zip:
Phone:	Fax:
Account #:
Contact Person:

I do hereby request that PET AIR, Inc. serve as our Professional Pet Travel Agent for shipments of live animals during the below listed dates / / through / / (Note: enter dates in mm/dd/yy format)

Signature ________________________________________________

Print Name
DATE

NON-REFUNDABLE APPLICATION FEE OF $25 MUST BE PAID BEFORE PROCESSING BEGINS

MC/VISA ACCT#:
EXP. DATE:
NAME ON CARD:
ADDDRESS:
CITY:	STATE:
ZIP:

FOR OFFICIAL USE ONLY: ACCEPTED BY PET AIR ________________________________ PETAIR SIGNATURE:_________________________________