BCSA Herding Instinct Evaluation - Entry Form
Type your information in the fields below then select the "print" option on your browser.
NOTE: ENTER INFORMATION BELOW AS YOU WOULD LIKE
 FOR IT TO APPEAR ON CERTIFICATE
OWNER(S):
ADDRESS:
CITY/STATE/ZIP:

TELEPHONE:
E-MAIL:   
CONFIRM E-MAIL:
   
REGISTERED NAME:
CALL NAME:   REGISTRATION NO:
   
INDICATE TIMES
YOU WOULD BE
AVAILABLE THURSDAY:
10:00-11:00 11:00-12:00 1:00-2:00 2:00-3:00 3:00-4:00 4:00-5:00

 

SIGNATURE: _________________________________________    DATE:

ENCLOSED:

Send entry and check payable to BCSA to:

  • Fee: $50 per dog or $40 per currently fostered rescue dog

  • Mail & Info: Linda Ramas – lulusdogs@hotmail.com - 5685 Tipple Road, Rockford, IL 61102
Office Use Only: Received _______________________  Check #: _____