WDSAA Breeder Endorsed Member Application

Breeder Endorsed Member Application

Application to be filled out by breeder who is a WDSAA Member
Breeder Endorsed Membership (BEM):

The Breeder Endorsed Membership is available to current WDSAA members who have produced a Dutch Shepherd litter and would like to offer their puppy buyers a one-time opportunity for a discounted WDSAA membership.

Breeder Endorsed Members receive access to members-only areas of the WDSAA website but are not eligible for scorebooks, voting privileges (unless otherwise specified), or WDSAA sponsorship. However, BE Members are welcome to upgrade to a full membership at any time.

Breeder Endorsed Membership is limited to individuals who have never previously been WDSAA members. The membership is valid only for the current membership year. For litters born after October 1st, please indicate whether you would prefer the membership to begin the following year.

Breeders may apply for Breeder Endorsed Memberships for past litters, provided they were WDSAA members at the time the litter was born.

Cost: $20 per individual
Breeder Name

First NameLast Name
Kennel Name
WDSAA Member #
How many puppy owners will you be endorsing today?

Puppy Owner #1
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #2
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #3
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #4
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #5
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #6
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #7
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #8
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)

Puppy Owner #9
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #10
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #11
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #12
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #13
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #14
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #15
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #16
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #17
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #18
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #19
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Puppy Owner #20
Owner Name

First NameLast Name
Email
example@example.com
City, State
Litter (e.g. Axel x Ash)
Litter DOB

MonthDayYear
Date

Litters born after Oct 1st only: Is membership to be applied to the current or following membership year. WDSAA membership year ends 2/28.

Current YearFollowing Year
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Breeder Endorsed Membership
$20.00 Total Number of Applicants

Total

$0.00
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