National Working Dog Association
Test Application
Please check the test you are entering:
____ BST (Breed Suitability Test) BST $45.00
____ OBT (Obedience Test) $35.00
____ WST (Working Suitability Test) $35.00
____ WTE (Working Temperament Evaluation) $25.00
____ AD (Endurance Test) $45.00
____SD1 (Sport Dog Test) $50.00
____SD2 (Sport Dog Test) $50.00
____SD3 (Sport Dog Test) $50.00
____PD1 (Protection Dog Test) $50.00
Test Location: _________________________________________ Test Date: ___________
Address: __________________________________________
City: ___________________ State: _______ Zip: _________
Owner Information:
Owners Name: _____________________________________
Address: __________________________________________
City: __________________ State: _______ Zip: __________
Phone Number: ______________ E-Mail: _________________
Handler Information:
Handler Name (If Different): __________________________
Canine Information:
Registered Name: ___________________________________
Breed of Dog: ________________________________ D.O.B___________________ Sex: _____
Call Name (If Any): ____________________________Score Book #_____________________
Reg. #____________________________________________
Tattoo/Microchip #__________________________________
I AGREE TO HOLD HARMLESS AND WAIVE ALL CLAIMS AGAINST ANY NWDA OFFICER, MEMBER, PARTICIPANTS, HOST CLUBS OR GROUNDS OWNERS AND THEIR HEIRS, ASSIGNEES OR REPRESENTATIVES FOR ANY INJURY, ACCIDENT OR LOSS WHICH MAY OCCUR AS A RESULT OF ATTENDING OR PARTICIPATING IN THIS EVENT.
Owner Signature: ________________________________ Date:____________
Handler Signature (if differant from above)___________________________ Date: _______________
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