Queensland Working Sheep Dog Association - Form of Application for Registration
For the Lease of registered dogs (dogs with Q number or corresponding state working sheep dog registration, that are to be trialled in QLD)
Details of Lesee(s)
(Temporary Owner)
Name
*
(New Owner)
Address
*
(Please include full address)
Phone Number
*
Email
example@example.com
Dog Particulars
Name of Dog
*
Registration No.
*
Lessor(s)
(Present/Registered Owner)
Name
*
Phone
*
Email
example@example.com
I/We being present Registered Owner(s) solemnly declare that we have disposed of this animal to the person(s) named above and hereby apply to register the Lease for the period and under the terms stated in the Lease Agreement.
*
Powered by
Jotform Sign
Clear
Effective Date of Commencement of Lease
*
-
Month
-
Day
Year
Termination Date
-
Month
-
Day
Year
Date
Registration transfer payment details
Please pay corresponding lease fee ($5) to Account name: Queensland Working Sheepdog Association Inc.; BSB: 484-799; Account Number: 204 296 370; Reference: (Your Name) dog transfer
Continue
Continue
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform