GERMAN SHEPHERD DOG CLUB OF AMERICA, INC. HERDING TRIALS

                            AMERICAN KENNEL CLUB ENTRY FORM

                WOLSTON FARM, SCIO, OREGON, OCT. 9, 10, AND 11, 2004

               LICENSED TRIALS 2004009302, 2004009303 AND 2004009318

              ENTRY IS LIMITED TO 40 RUNS FOR EACH JUDGE EACH DAY

        Please indicate below the classes and days of your entries.  Separate entries for

                         EACH DOG, please. You may enter all trials on this form.

PLEASE NOTE THIS*******MONDAY IS GERMAN SHEPHERDS ONLY***

HERDING TEST-SAT___SUN___MON­­­___     NON-REGULAR CLASSES-MON.

 PRE-TRIAL TEST-SAT___SUN___MON___  RANCH DOG COURSE-$45.00

 COURSE A                                                      COURSE B___________________

ADVANCED-SAT___SUN___MON___       ADV-SAT___SUN___MON___

 INTERMED-SAT___SUN___MON___        INT-SAT___SUN____MON___

 STARTED-SAT___SUN___MON___           STARTED-SAT___SUN___MON___

COURSE C

ADVANCED-SAT___SUN___MON___        INTERMED.-SAT___SUN___MON___

                                         STARTED-SAT___SUN___MON___

RANCH COURSE-MONDAY ONLY-STARTED___INTER____ADV____    

ENTRY FEES ARE $45.00 FOR EACH TRIAL TEST AND RANCH COURSE

EXCEPT FOR COURSE C, WHICH WILL BE $65.00_____________________

MONDAY, ALL TRIALS ARE OPEN TO GERMAN SHEPHERD DOGS ONLY

 Make entries payable to the GSDCA-HERDING. And mail to Doris Estabrook,

 Trial Secretary 1908 Sorrel Lane, Gardnerville, NV 89410 Phone 775 265-1703

Entries will close at the secretary’s address  at 7PM  SEPTEMBER 18, 2004, after

Which time entries cannot be accepted or changes made except as provided for in

 Chapter 3 Section 1 of the Herding Regulations. PLEASE NOTE EARLY CLOSE.

BREED_______________________________SEX________________________

DOG’S FULL NAME_____________________________________________________

AKC REG.NO. OR AKC ILP NO.__________________________________________

DATE OF BIRTH____________BIRTHPLACE___USA___CAN___FOREIGN

IF FOREIGN, REG. NO____________________COUNTRY____________________

BREEDER______________________________________________________________

SIRE___________________________________________________________________

DAM___________________________________________________________________

OWNER(S)_____________________________________________________________

 ADDRESS_____________________________________________________________

I certify that I am the actual owner or duly authorized agent of the owner whose

 name I have entered above.  In consideration of the acceptance of this entry I (we)

 agree to abide by the rules and regulations of the AKC in effect at the time of these

 tests and trials, and by any additional rules and regulations appearing in the

Premium List. I (we) certify that this dog is not a hazard to persons or other dogs.

 This entry is submitted on the foregoing representation and agreement.

SIGNATURE OF OWNER OR AGENT_____________________________________

EMAIL AND PHONE NUMBER___________________________________________