This entry is not complete until payment OF $40.00 PER HONOR ROLL DOG LISTING is received. For those sending hard copy photo, an additional charge of $5.00 per entry is assessed to cover shipping, managing and scanning costs. Please add that to your check or select that option in the store

ENTRY DEADLINE IS APRIL 1, 2020

Entries should be made by inputting your information to Formsite and THEN GOING TO THE PWCCA STORE to place your system order and choose your payment method. For those opting to pay offline, Please make checks payable to PWCCA and mail to C. Donnelly Editor 10 Powissett St. Dover MA 02030

*** ENTRIES ARE PRINTED IN FULL COLOR****
NO ENTRIES WILL BE ACCEPTED THAT ARE INPUT WITH YOUR CAPS LOCK ON. WE WILL NOT RETYPE THE ENTIRE ENTRY. PLEASE DOUBLE CHECK SPELLING AND GRAMMER, AND USE SPACES NOT COMMAS BETWEEN TITLES! Thank you!

PLEASE ENTER YOUR DOG'S NAME AS IT APPEARS IN HIS/HER AKC RECORD AS OF 12/31/2019, including all prefix and suffix AKC Titles ONLY Please! This is what we will use for your Dog's Name under the Photo *

Call Name: *

Color: *

Red & White

Red Headed Tricolor

Black Headed Tricolor

Sable & White

Sex: *

Male

Female

Dog's Date Of Birth * +

TITLES EARNED IN 2019 ONLY! BELOW, PLEASE ENTER ONLY THE TITLES YOUR DOG HAS EARNED IN 2019

PREFIX TITLES

LIST ALL AKC RECOGNIZED CONFORMATION CHAMPION (PREFIX ) TITLES HERE

LIST ALL AKC RECOGNIZED PERFORMANCE CHAMPION (PREFIX ) TITLES HERE

LIST ALL AKC RECOGNIZED SPECIAL (PREFIX ) TITLES HERE

AKC RECOGNIZED SUFFIX TITLES

LIST ALL AKC RECOGNIZED SUFFIX TITLES EARNED IN 2019 HERE

ANY SPECIAL WINS OR PLACEMENTS (such as Specialty wins, invitational attendance, national championships attendance etc.) NO STORIES ARE ALLOWED, First place is NOT a special win for this purpose! NO CLEARANCES, OFFSPRING ACCOMPLISHMENTS ETC. *

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PWCCA SPECIFIC TITLES

PWCCA SUFFIX AWARDS

	ROM	ROMX	VC	VCX
REGISTER OF MERIT	ROM	ROMX	VC	VCX
VERSATILITY	ROM	ROMX	VC	VCX

OWNER INFORMATION

Owner's First Name *

Owner's Last Name *

Street Address *

Address Line 2

City *

State/Province/Region/Country *

Zip/Postal Code *

Phone Number *

email address *

ALL CO-OWNERS (First and Last Names). *

ALL Breeders of Record (First and Last Names): *

PEDIGREE INFORMATION

PEDIGREE INFORMATION SIRE *

PEDIGREE INFORMATION Sire's Parentage 2nd Generation

	Sire's Parentage 2nd Generation
Sire's Sire	Sire's Parentage 2nd Generation
Sire's Dam	Sire's Parentage 2nd Generation

PEDIGREE INFORMATION Sire's Parentage Third Generation

	Third Generation Sire's Side
Sire's Grand Sire (Sire's side)	Third Generation Sire's Side
Sire's Grand Dam (Sire's side)	Third Generation Sire's Side
Sire's Grand Sire (Dam's side)	Third Generation Sire's Side
Sire's Grand Dam (Dam's side)	Third Generation Sire's Side

PEDIGREE INFORMATION DAM *

PEDIGREE INFORMATION Dam's Parentage 2nd Generation

	Dam's Parentage 2nd Generation
Dam's Sire	Dam's Parentage 2nd Generation
Dam's Dam	Dam's Parentage 2nd Generation

PEDIGREE INFORMATION Dam's Parentage Third Generation

	Third Generation Dam's Side
Dam's Grand Sire (Sire's side)	Third Generation Dam's Side
Dam's Grand Dam (Sire's side)	Third Generation Dam's Side
Dam's Grand Sire (Dam's side)	Third Generation Dam's Side
Dam's Grand Dam (Dam's side)	Third Generation Dam's Side

PHOTOGRAPHY INFORMATION

NO COLLAGES ALLOWED. DOG ONLY, PEOPLE ARE CROPPED OUT. SINGLE FOCUSED PHOTO. Please upload your photo here. It must be a minimum of 300dpi resolution and AND min. 4"X6". FILE SIZE SHOULD SAY IT IS OVER 1MB (OR AT LEAST 900KB). 🛈

Photographer Credit *