SPINONE CLUB OF AMERICA
NATIONAL SPECIALTY

APRIL 26 - APRIL 30, 2000

NAVHDA Official Test Entry
revised 9/99

Please print this form using your browser's print command and mail to
Larry Dickey, 45310 St. Rt. 154, New Waterford, OH 44445
 Make checks payable in U.S. funds to the Rappahannock Chapter.

Chapter:  RAPPAHANNOCK CHAPTER  Test Dates April 28, 29, 30

Preferred Running Day? ___________________

please circle: Natural Ability($75)  Utility Preparatory($100)  Utility($100)  Invitational

Type or print clearly and attach a COPY of Registration, Litter Paper or Pedigree
NAVHDA Registered? (circle)      Yes       No NAVHDA Registration # _______________
(copy of pedigree not necessary if NAVHDA registered)
Dog Previously NAVHDA Tested (please circle) Yes           No
If Not Registered with NAVHDA,
Other Registration # ______________________		 Registered With (circle):
AKC       CKC       American Field       VDD
Registered Name ________________________________________    (circle):    Male         Female
Call Name _____________________________ Whelp Date: Mo ____ Day ____ Yr ____
Breed of Dog ___________________________ Color________________________________
Breeder's Name _________________________
Sire ___________________________________ Dam ___________________________________
Owner ________________________________ Your NAVHDA Member # _______________
Street _________________________________ Phone ( ______ ) ________-_____________
City ___________________________________ State/Prov ______ Postal Code ___________
Email __________________________________
Handler ________________________________ Phone ( ______ ) ________-_____________
If handler is a NAVHDA Judge, please indicate Yes ____ Number________________
Hip Dysplasia X-Rayed? ___Yes ___No (Include copy of X-Ray results - OFA, Berlin, Guelph, PennHip) It is recommended that dogs over 24 months of age have their hips X-Rayed.Age of Dog on Test Day: (Natural Ability) ___ Months (UPT/UT/INVIT) ___Years ___ Months
IMPORTANT! Dogs are eligible for a Natural Ability Test up until, and including, the day they reach 16 months of age. Dogs over 16 months may be tested for evaluation. No Prize Classifications are awarded dogs tested for evaluation. Dogs over 16 months may be tested if space is available.
To Make Your Entry Complete Include the Following Items:
This application filled out legibly and completely.
Copy of registration certificate (not necessary for NAVHDA registered dog).
Entry fee in the form of check or money order. Do not send cash.
Copy of hip dysplasia X-Ray evaluation (if applicable).

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