Certification Test Score Sheet

K9 Team Certification Test Sheet
Some pages/sections of this form may not apply during each test event and may be completed as applicable throughout the testing period. Page 1; however, is required to be filled out in its entirety prior to final submission.
Master Trainer Pre-Submission Verification*

I understand the above statement.
UPWDA Membership Verification*

No, not a current UPWDA member. A $50 fee/test sheet will be assessed.Yes, I have confirmed current UPWDA membership.
Date of Test*

MonthDayYear
Date
Handler's Name*

First NameLast Name
Handler's Email Address*
example@example.com
Handler's Phone Number*
Please enter a valid phone number.
Handler's Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Supervisor's Email Address*
example@example.com
Employer Name*
Employer Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone Number*
Please enter a valid phone number.
K9 Name*
K9 Age (in years)*
K9 Breed*
K9 Color*
K9 Gender*

MaleFemale

Phases Tested In

	Pass	Fail	Master Trainer	Test Date
Obedience
Article Search
Area Search
Building Search
Obedience/Aggression Control
Trailing Level 1
Narcotic Detection
Explosive Detection
Firearms Detection

Specify each specific odor passed. Please write out odors in this format ONLY: Cocaine, Methamphetamine, Semtex, PETN, SP1-Single Base smokeless Powder, etc. If no odors are used, please write N/A.
I have typed out each odor, spelled correctly, with no abbreviations, separated by commas. I understand that if I do not fill out the above information correctly, a Certificate will not be produced.

YesN/A

Detector Dog Search Tests
#1 Building Search Test
Please acknowledge one of the options below.*

This section does not apply to me right now.This section does apply to me right now and I will include my name and signature below.
Location:
Weather:
Set Time:
Run Time:
Number of Rooms:
Number Blank:

Detector Dog Search Tests
#2 Vehicle Search Test
Please acknowledge one of the options below.*

This section does not apply to me right now.This section does apply to me right now and I will include my name and signature below.
Location:
Weather:
Set Time:
Run Time:
Number of Vehicles:
Number Blank:

Detector Dog Search Tests
#3 Container, Locker, Etc. Search Test
Please acknowledge one of the options below.*

This section does not apply to me right now.This section does apply to me right now and I will include my name and signature below.
Location:
Weather:
Set Time:
Run Time:
Number of Items Searched:
Number Blank:

Detector Dog Search Tests
#4 Open Area Search Test
Please acknowledge one of the options below.*

This section does not apply to me right now.This section does apply to me right now and I will include my name and signature below.
Location:
Weather:
Set Time:
Run Time:
Size of Area Being Searched:

Final Review and Acknowledgment
Some pages/sections of this form may not apply during each test event and may be completed as applicable throughout the testing period. Page 1; however, is required to be filled out in its entirety prior to final submission.
Master Trainer Pre-Submission Verification*

I understand the above statement
Master Trainer Name*

First NameLast Name
Master Trainer Email*
example@example.com
Master Trainer Signature:*

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K9 Team Certification Test Sheet