Submission Form for TrailDog, PackDog, and CycleDog Titles

Submission Form for TrailDog, PackDog and CycleDog Titles
Person's Name(s)*
Dog's Name*
Please include names as you would like them to read on your certificate.
E mail*
example@example.com
Does Your Dog Have a Competition Registration Number (CRN)?*

YesNo
Dog's CRN Number
TrailDog Title Achieved

TDTDXUTUT500UT750UT1KUT(x)K (specify number of miles below)
Number of Miles for UT(x)K
PackDog Title Achieved

PDPDXUPUP500UP750UP1KUP(x)K (specify number of miles below)
Number of Miles for UP(x)K
CycleDog Title Achieved

CDCDXUCUC500UC750UC1KUC(x)K (specify number of miles below)
Number of Miles for UC(x)K
Date title was achieved. If you are submitting more than one title please provide the additional title(s) and date(s) in the field below.

MonthDayYear
Date
Additional title(s) and date(s)
One title/date per line. Example TDX - 01/01/2021
Attach your mileage log(s).

Please include your log sheets (or certificate) for previously completed levels.
Cancelof
A title patch will be awarded for the first level title earned in each category. Extra patches cost $3

A mileage patch will be awarded for subsequent levels. Extra mileage patches can be purchased for $3 each.
Are billing and shipping address the same?

yesno
Shipping Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My Products
prevnext( X )
Title Recording FeeFee for having your title recorded by DSA
$25.00 How many titles are you submitting?
Item subtotal:$0.00



DSA CRN registration for membersSelect this option if you are a DSA member and need a CRN
$15.00



DSA CRN registration for non-membersSelect this option if you are not a DSA member and need a CRN
$20.00



Extra Title PatchesIf you want extra patches for more than one title please email us the details to titles@dogscouts.org
$3.00 Quantity



Extra Mileage PatchesIf you want extra patches for more than one title please email us the details to titles@dogscouts.org
$3.00 Quantity



Total

$0.00
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Submission Form for TrailDog, PackDog and CycleDog Titles