WAE Waiver to Publish Passing Scores

Waiver to Publish Passing Scores
Passing scores from Working Aptitude Evaluations before March 2, 2011 were not approved to be published. If your dog earned a passing score in a prior evaluation and you wish to have that score published on dpca.org, complete this waiver, sign where indicated, and this form will be forwarded to the WAE Secretary.
Registered name of dog*
AKC Reg#*
Date of birth*

MonthDayYear
Date
Gender*

MaleFemale
Date of WAE*

MonthDayYear
Date
Evaluator*
Name of owner(s)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: