2025 Diving Dog QUALIFIER
EASTERN REGIONALS QUALIFIER Registration + Bio Form
Name
*
First Name
Last Name
Limited Spots Available. Once full please use the link below to join the waitlist.
*
Use this link to be added to the WAITLIST.
https://form.jotform.com/250796725177065
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Phonetic Spelling of Name
Dog Name
*
Dog Breed
*
Dog Age
*
Dog Sex
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What food do you primarily feed?
*
Please Select
Purina Pro Plan Sport
Purina Pro Plan Focus
Purina Pro Plan Complete Essentials
Purina Pro Plan Sensitive Stomach
Purina Pro Plan Other
Other Brand Name Food
What other brand food?
List any PPPIDC Results (if applicable)
*
Outside of PPPIDC, list any other accomplishments that might be relevant (if applicable)
*
Is your dog a rescue?
*
Yes
No
If yes, where did you rescue your dog from?
*
How did you get started in the Sport?
*
Specific to competition, describe your dog’s strengths (what separates him/her from other dogs):
*
How did you come up with your dog’s name?
*
Describe one thing unique about your dog that would be interesting to the audience:
*
Outside of competition, are there any unique or special things your dog does or is involved in?
*
Shirt Size (unisex shirts)
*
Small
Medium
Large
XL
XXL
XXXL
Dock Handler Shirt Size
*
Small
Medium
Large
XL
XXL
XXXL
No shirt needed! It's just me!
Will your require a space in our crating tent?
*
Yes
No
Will you be bringing an RV - RV arrival window (Thursday April 10th 3pm or later)
Yes
No
Instagram Handle {handler/dog (if applicable)} - Write N/A if none
*
TikTok Handle {handler/dog (if applicable)} - Write N/A if none
*
Are you comfortable with Purina tagging your personal accounts (handler and/or dog) on social
*
Yes
No
Handler Birth Year Range
*
1928 - 1945
1946 - 1954
1955 - 1964
1965 - 1989
1981 - 1996
1997 - 2012
Submit
Should be Empty: