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CALENDAR ENTRY – 2016
Step 1: Please complete this form
Step 2: Provide a photo(s) of your dog (outside, inside, Christmas, Halloween…whatever you’d like!!)
Step 3: Email the completed form and photo(s) to katherine@synterratech.com
YOUR NAME:
Address:
City / Province /State / Country:
Email:
Cell:
Home:
DOG’S NAME:
DOG’S ADOPTED NAME:
Postal / Zip:
Work:
Other:
COMMENTS ABOUT YOUR DOG: _____________________________________________________________
(We would like to put a comment from you on the calendar with your dog’s picture)
COMMENTS ABOUT DINO: __________________________________________________________________
(EG. YOU LOVE US!  )
FAMILY NAMES YOU WOULD LIKE LISTED WITH YOUR DOG’s PHOTO (we just use first names):
__________________________________________________________________________________________
By signing here, I am consenting to DINO using my photo(s) and comments in their DINO calendars. Permission
is also given to use photos with children under the age of 18, with this signed consent.
Signature(s): ___________________________ Date:____________________________________