BCSA: SOD Award Form

STOCKDOG OF DISTINCTION AWARD FORM - BCSA Members Only
Maximize page for easier entry.

Enter your and your dog's information AS YOU WOULD LIKE FOR IT TO APPEAR ON YOUR
CERTIFICATE, in the form below, print and mail along with COPIES of your proof of requirements to:
Claudia Frank - 5373 SR 138 NE, Greenfield, OH 45123-9518

MEMBER NAME:

ADDRESS:

CITY/STATE/ZIP:

TELEPHONE:

E-MAIL:

CONFIRM E-MAIL:

REGISTERED NAME:

CALL NAME:

REQUIREMENTS CHECK LIST:

Only copies should be submitted. We cannot be responsible for originals

AKC herding championship title, and

ASCA WTCH or AHBA HTCH, and

Five points from USBCHA sanctioned open trials

SIGNATURE: _________________________________________ DATE:

Office Use Only: Received _______________________ Verified: _____ Cert Mailed: _____