PEDIGREE SUBMISSION FORM
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verify your information before clicking on SUBMIT INFO.

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Please enter your E-MAIL address. This is a REQUIRED field.

An invalid e-mail address will cause the information submitted to not be added to our database.
Please enter your REAL name. NOTE: This information is for our records ONLY

DOG INFORMATION

REGISTERED NAME (Do NOT include titles)
 		CALL NAME

PREFIX TITLES (Check all that apply)

CHAMPION (Specify) American Argentina Australian Brazilian British
Canadian Finnish French German International
Luxenberg Mexican New Zealand Peru Venezualan

Additional American Champion Prefixes (Check all that apply)

FC - Field Champion AFC - Amateur Field Champion
NFC - National Field Champion NAFC - National Amateur Field Champion
NOC - National Obedience Champion OTCH - Obedience Trial Champion
MACH - Master Agility Champion HC - Herding Champion
DC - Dual Champion (CH & FC) TC - Triple Champion (CH, FC & OTCH)
CT - Champion Tracker (TD, TDX & VST)

SUFFIX TITLES (Check all that apply)

CD - Companion Dog CDX - Companion Dog Excellent
UD - Utility Dog UDX - Utility Dog Excellent
TD - Tracking Dog TDX - Tracking Dog Excellent
VST - Variable Surface Tracker UDTD (UDT) - Utility Dog Tracking Dog,
Utility Dog Tracking
UDTDX - Utility Dog Tracking Dog Excellent UDXTD - Utility Dog Excellent Tracking Dog
UDXTDX - Utility Dog Excellent UDVST - Utility Dog Variable Surface Tracking
Tracking Dog Excellent
UDXVST - Utility Dog Excellent JH - Junior Herding
Variable Surface Tracker
SH - Senior Herding MH - Master Herding
HT - Herding Tested PT - Pre-Trial Tested
HS - Herding Started HI - Herding Intermediate
HX - Herding Excellent JC - Junior Courser
SC - Senior Courser MC - Master Courser
NA - Novice Agility OA - Open Agility
AX - Agility Excellent MX - Master Agility Excellent
NAJ - Novice Jumpers With Weavers OAJ - Open Jumpers With Weavers
AXJ - Excellent Jumpers With Weavers MXJ - Master Excellent Jumpers With Weavers
JE - Junior Earthdog SE - Senior Earthdog
ME - Master Earthdog

Registration Number (AKC, CKC, etc.) Whelped (MM/DD/YYYY format)
Select 1 (one) of the following colors. If the color is not listed, please send an e-mail to us indicating the color..

Please select the sex of the dog. MALE FEMALE
If the dog has been bred, please indicate the STUD BOOK Entry Date: (Format is MM-YYYY)
HEALTH TESTS PERFORMED:

If this dog has had hip x-rays completed, please indicate which test was performed, certificate number issued
and date test was performed.

Test Performed Cert# Date: (Format is MM-DD-YYYY)

If this dog has had eyes checked by a qualified opthomologist, please indicate the CERF number,
stats (Clear, etc.) and date.

SLT/PRA# Status: Date: (Format is MM-DD-YYYY)

Please indicate any other type of health tests performed, such as Thyroid, etc.

Please indicate the name(s) of the breeder(s). Seperate names with a comma.
Please indicate the name(s) of the owner(s). Seperate names with a comma.
Please list the SIRE and DAM, including any TITLES:
SIRE :
DAM :

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