RTCA VERSATILITY AWARD APPLICATION

RTCA VERSATILITY AWARD APPLICATION
Owner Information

The owner on record of the dog must be a member of the RTCA in good standing, and be the individual submitting the application.The owner(s) do not have to be the handler at the time the dog received a title.
Owner Name*

First NameLast Name
Additional Owner(s)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Active RTCA Member in good standing?*

YesNo - Please become a member before completing this form!
By submitting an application, you agree to allow the RTCA to use your photos, name and dog's name on social platforms, electronic and printed publications.*

I agree
Dog Information

The Rat Terrier, living or deceased, must be registered with the AKC. AKC, PAL & ILP # accepted.
Registration Number*
Registered Name (NO TITLES)*
Date Of Birth*

MonthDayYear
Date
Sex*

DogBitch
Call Name*

Owner Information