TORC
Title Submission
Name
*
E-mail
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Dog's full name as you would like it to appear on your certificate
*
Date title earned
-
Month
-
Day
Year
Date
My dog's score:
TORC Judge:
Elizabeth Clark
Michael Carroll
Vicki Charikofsky
Kelly Comerford
Dee Hart
Leslie Horan
Debra Jones
Chrissy Joy
Lauren MacKenzie
Christina McCauley
Anne Poirier
Kathleen Poniatowski
Diane Sammarco
Kirsten Zabicki
Wendy Zabicki
Location of TORC trial
Questions or Comments:
Title I am submitting
You and your dog will be recorded on the public record (if you do not wish to be listed, just let us know)
I earned:
TORC Achiever (TORC-A)
TORC Excellent (TORC-E)
TORC Master (TORC-M)
TORC M1X
TORC M2X
TORC M3X
TORC Grand Master (TORC-GM)
My Products
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Title Submission
$
20.00
Receive an official title certificate for your TORC achievement
Commemorative Rosette
$
20.00
Official Rosettes to proudly display along with your title certificate
Select your Rosette
TORC Achiever (TORC-A)
TORC Excellent (TORC-E)
TORC Master (TORC-M)
TORC Grand Master (TORC-GM)
Quantity
1
2
3
4
5
6
7
8
9
10
Advanced Designation Pins
$
3.00
Available for TORC-M1X, TORC-M2X, TORC-M3X
Quantity
1
2
3
4
5
6
7
8
9
10
TORC Grand Master Medallion
$
15.00
A handsome wearable medallion for the prestigious title of TORC Grand Master
Test item
$
1.00
Subtotal
$
0.00
Shipping
$
0.00
Total
$
0.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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