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Nova Scotia Duck Tolling Retriever Club (USA)

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2008 National

Admiral Halsey HOT Dog Teamwork Award
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 or co-owner of record for the dog listed.
  • Applications are due each year by August 25 to include titles 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*  
AKC FIELD TITLE(S)
AWARDED*		  
Check All Titles That Apply JH; SH; MH; FC; AFC
Title Completion Date(s)*  

Names and Phone Numbers of Amateurs or Professional Trainers I worked with:

Training Date Periods :

 
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 of said dog and with my co-owner(s) fully trained and handled the dog to the title for which I am making application.
   Yes No

Enter your name as signatory*: 

Enter any co-owners in the spaces provided below & check if they assisted in training and/or handling:

  Yes, assisted.
  Yes, assisted.

Any additional comments:

Questions?  Contact Kim Simons.
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