E-Mail Address:

Name:

Mailing Address:

City:    State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY    Zip Code:

Home Phone: (e.g. 305-555-5555)

Work Phone:    Cell Phone:

Species (be specific):

Overall Length in Inches (tip of nose to tip of tail):

Girth (if known):

Questions/Additional Info:

Don't forget to e-mail your pictures to: ellis@ellisoutdoors.com!