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Dog's Name: ______________________________________________________

Call Name: ____________________________  Date of Birth: ______________

Country of Origin: ______________________  Tattoo: ___________________

Sex:    ____ male      ____ female         Neutered:    ____ yes      ____ no

Color:    ____ black/gold     ____ blond    ____ black

FCI registered:    ____ yes      ____ no

Two copies of the pedigree are required. Check each of the following documents for which copies are also enclosed (no originals):

____  OFA results (or HD results from country of origin)

____  CERF results

____  Certificates confirming show and working titles

____  Temperament test results

____  Description of health/genetic characteristics (e.g. hips, thyroid):

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