Obedience Title Application

All dogs participating in the program for an Obedience Title must be registered with the American Dog Federation.If your dog is not
registered with the American Dog Federation you can submit an application for individual registration with the required fee along with this
application. All video's and applications become the property of the  American Dog Federation.

Breed:_________________________________________________Registration#______________________

Name of Dog:__________________________________________________(  )male    (   ) female

Owners Name:________________________________________________________________

Address:_____________________________________________________________________

City:_______________________________________State:______________Zip:____________

Phone:(area code first)____________________Phone: (area code first)___________________

Please check the following   (    )Conformation      (    )Obedience   (    ) Tracking     (    )Other____________________   
Fee per test/video $50.00
members of the American Dog Federation please deduct $10.00 per test/video
If you are a member of the American Dog Federation please enter your membership ID here________________________

Method of Payment:(   )Visa    (   )Master Card   (   )Discover   (   )Check    (   )Money Order                                   

Name on credit card(please print)_________________________________________________

Credit Card Number__________________________________________Exp.Date_____/_____

Cardholder authorizes this charge

Signature of card holder__________________________________________Date____/____/_______

Mail Payment and Video to:  American Dog Federation
Phone: 989-644-0410           138 Lanes Mill Road
                                        Howell, New Jersey 07731

 
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