AMERICAN DOG FEDERATION

        Application for Testing


All dogs participating in the Champion Certification program must be registered with the ADF.If your dog is not registered with the
ADF you may submit an individual application for registration with the required fee along with this application.
All video tapes and applications become the property of the American Dog Federation. Certificate and ribbon will be
issued within 3 weeks of submission. Once your video has been approved any and or all fees are not refundable. All decisions of judges
are final.
If your video is not approved a processing fee of $20.00 will not be refunded.
Please print clearly
Check the title you are applying for: (   )CHAMPIONSHIP CERTIFICATE      (   )MERIT CHAMPION CERTIFICATE

Breed:_______________________________________________Registration #_________________________

Dog Of Unknown Origin: Registration #_______________________________

Date of Birth____/_____/________  Male(   )    Female(   )    Neutered(   )   Spayed(   )
_
Name of Dog:_____________________________________________________________________________

Owners Name:____________________________________________________________________________

Address:__________________________________________________________________________________

City:________________________________________________State/Country:___________________Postal/Zip:_________________
      One of our representatives will call you after the judges view your video

Best time to call___________________ Phone #_____________________________________




Method Of Payment:    
(   ) Credit Card    (   )Check   (   ) Money Order     Fee:$125.00 check the coupons page for available promotions

Name on credit card(please print):______________________________________________________________

Credit Card #___________________________________________________________Exp.Date_____/______
Cardholder authorizes this charge
Card Holders Signature:___________________________________________________Date:____/_____/____

Please mail to:                                  Printable Page or Copy and Paste
American Dog Federation
PO Box 238
Barryton, Michigan 49305
Conformation Test
989-433-8010

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