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Nova Scotia Duck Tolling Retriever Club (USA)

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2008 National

Evelyn A. Williams Award of Excellence
APPLICATION

  • Please read the award description and rules before completing this form.  CLICK HERE for a PDF copy.
  • To be accepted, this form must be completed by the owner/handler of record for the dog listed.
  • Applications are due each year by August 25 to include titles/achievements earned during the previous club title year: July 1 through June 30.
  • If the award is not picked up during the National Specialty weekend, it will be mailed to the person completing the form.

Please provide the following information:
(Items marked with an asterisk (*) are required.)

First Name*  
Last Name*  
Street Address*  
Address (cont.)
City*  
State/Province*  
Zip/Postal Code*  
Country
(If not in US)
Home Phone
E-mail*  

Information about your Toller:

Registered Name*  
Sex Male Female
Registration Number*  
Country & Registry in which
Title/Achievement Awarded*		  
Venues*  
Check All  That Apply Conformation; Obedience; Rally; Field Tests;
 Field Trials; Tracking; Agility
TITLES If more than 4, add additional to Comment section.
For titles/achievements awarded through the NSDTRC (USA) or the AKC, no additional documentation besides this form is required.
1. Title  
2. Title  
3. Title  
4. Title  
ACHIEVEMENTS If more than 3, add additional to Comment section.
1. Achievement  
2. Achievement  
3. Achievement  
  Please complete the information under Additional Information if you have listed an achievement in conformation, obedience, field, or agility.

Documentation Requirements:

  • For titles/achievements awarded through the NSDTRC (USA) or the AKC, no additional documentation besides this form is required.
  • For titles awarded that are NOT a part of the NSDTRC (USA) title program or the AKC, please mail a copy of the award certificate. Note: If the title was obtained from a non-English speaking country, please enclose an explanation of the title and the requirements for obtaining such a title in English.
  • For achievements awarded that are NOT in conjunction with a NSDTRC (USA) sponsored event, please provide the name of the event, location, date, Secretary, email address and phone number plus one of the items listed below for verification of the achievement:
Name of Event  
Date  
Location  
Secretary
Phone  
Email  
  • Copy of a picture taken by the official show photographer that has a legible representation of the name and date of the event and the achievement, i.e. BIS, HIT, or
  • Copy of the Judging Program or catalog page(s) that list the total number of entries in an all-breed show or if a Specialty or Supported Entry, a copy of the breakdown of entries, or
  • Copy of the page from an official publication listing the achievement. Examples: Dogs in Canada, NAHRA News, Bloodlines, or
  • A written statement signed and dated by the Secretary of the event attesting to the achievement and that the attendant requirements were met.

Additional Information

Please provide the appropriate information below as it pertains to the venue in which you believe you have met the requirements for this award:

ACHIEVEMENTS

Conformation
Club Sponsoring Event:
Best in Specialty: Number of Dogs Exhibited Points Awarded
Number of Bitches Exhibited Points Awarded
Number of Specials in BOB
Best of Breed (Supported Entry): Number of Dogs Exhibited Points Awarded
Number of Bitches Exhibited Points Awarded
Number of Specials in BOB
Best in Show, All Breed: Number of Entries in show
Invitational, All Breed: Group Placement
Obedience Trial
Club Sponsoring Event:
Score in Regular Classes:  
Must be 198 or higher		 Score Class Entered
High in Trial:
Must be 195 or higher 		Score Class Entered
High Combined:
Must be 380 or higher 		Open B Score Utility Score Total
Invitational Obedience Trial
Organization Sponsoring Event:
Class Entered Score Placement
Invitational Agility Trial
Organization Sponsoring Event:
Number exhibited in height division Score Placement
Invitational Field Test/Field Trial
Organization Sponsoring Event:
Number of stakes offered Number of stakes qualified

I certify that I am a member in good standing with full voting privileges in the Nova Scotia Duck Tolling Retriever Club (USA). I further certify that I was the owner/co-owner of said dog and handled the dog to the title and/or achievement for which I am making application.
  Yes No

Enter your name as signatory*:   

Any additional comments:

To receive the award, mail any required documents to:
Kim Simons ~ 19223 Prairie St. ~ Northridge, CA 91501

Questions?  Contact Kim Simons

Application Deadline - August 25th

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