Versatility Enrollment Form

Please refer to the Versatility Program Handbook for program information and rules.

Name

First NameLast Name

Membership Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail

example@example.com

Phone Number

Dog's Registered Name

Dog's Call Name

How to print Dog's name on Title Certificate?

Dog's SCPS Registration Number

😊 Would you like to submit your first Title with your Enrollment today?

I am applying for the following Title:

R-I - 5 Points across 3 Categories.
R-II - 10 Points across 3 Categories.
R-III - 20 Points across 3 Categories.

A-I - 5 Points across all 5 Categories.
A-II - 10 Points across all 5 Categories.
A-III - 20 Points across all 5 Categories.

If you are applying for the Scottish Collie Hero Award, please fill out the top box only of this form and email the judges' panel with your story and documentation. Send to president@scottishcolliepreservationsociety.org.

Categories & Accomplishments

Below, please briefly list your dog's Accomplishments across at least 3 Categories (R-I, R-II, R-III), or 5 Accomplishments across all 5 Categories (A-I, A-II, A-III) for which you are submitting documentation. Please refer to the Handbook for details.

My dog has Accomplishments in the following Categories:

Please list your dog's Accomplishments in Health and Soundness, and any links to documentation:

Please upload an image of each supporting document per Accomplishment in Health and Soundness:

Upload

Please list your dog's Accomplishments in Herding, and any links to documentation:

Please upload an image of each supporting document per Accomplishment in Herding:

Upload

Please list your dog's Accomplishments in Other Farm/Ranch Skills, and any links to documentation:

Please upload an image of each supporting document per Accomplishment in Other Farm/Ranch Skills:

Upload

📌 You have listed Accomplishments in Categories 2 and 3, which means that your dog could be eligible for one of the SCPS Farm Dog Designations. Would you like us to add that to his review?

Please list your dog's Accomplishments in Other Work and Sports, and any links to documentation:

Please upload an image of each supporting document per Accomplishment in Other Work and Sports:

Upload

Please list your dog's Accomplishments in Service, Assistance, and Education, and any links to documentation:

Please upload an image of each supporting document per Accomplishment in Service, Assistance, and Education:

Upload

My Products

Versatility Program Fee$15.00

Total $0.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

By submitting this form I agree to abide by the SCPS Code of Ethics and confirm that I am acting in a sportsmanlike manner. I agree that all Versatility Program Title information and documentation that I submit is, to the best of my knowledge, accurate and correct. I acknowledge and agree to pay listed fees to join the program and to receive subsequent titles, as invoiced.

Versatility Enrollment Form

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My Products*

My Products