HOLOHIL SYSTEMS LTD.
112 John Cavanaugh Drive
Carp, Ontario, Canada K0A 1L0
Tel: 613-839-0676 - Fax: 613-839-0675
E-mail: info@holohil.com

 FOR OFFICE USE
Job#
File#

TRANSMITTER
Model: Quantity: Delivery Date:
Model: Quantity: Delivery Date:
Weight: Life: Attachment:
Special instructions:



ANIMAL

Species:
Weight/Neck Size - Male: Female:
Habitat: Study Location:

FREQUENCY

Receiver Frequency Range(MHz): Increments(kHz): Model:
Frequencies to avoid:


SHIPPING ADDRESS BILLING ADDRESS
Name: Name:
Organization: Organization:
Address: Address:






Tel: Tel:
Fax: Fax:
E-mail: E-mail:
Purchase Order No. (if applicable):

FOR OFFICE USE

$ Serial #