Futurity Litter Nominations 2004

Litter Nomination Form
German Shepherd Dog Club of America, Inc.
2005 National Futurity
Litters Whelped Oct. 1, 2003-Sept 30, 2004. Litter Nominations close January 1, 2005

Breeder or Co-Breeder of the AKC registered litter must be a member of the GSDCA or must apply with this nomination.
An individual owner may nominate a litter, but this form must be signed by the breeder and the breeder must nominate the litter in the region which the breeder resides.
Nomination fee will be $25.00 per litter for members of the GSDCA or those applying for membership with an enclosed form and fee. Nomination is limited to members of the GSDCA or applicants for membership. Nomination is extended to 120 days by paying late fees of $50.00 in addition to the $25.00 or until nominations close with a late fee of $100.00
No fee may be refunded.
Make check or money order (in US funds only) payable to GSDC of A.
Forward completed litter nomination and fee to JIM RAU DOG SHOWS within 90 days following date of whelping.
A four generation pedigree must be submitted with this nomination.

Date of Whelping:

Month_____ Day _____ Year _____

Date of this nomination:

Month ____ Day ___ Year ___

Number of Puppies _____

Sire:_______________________________________________________ AKC #:_________________________

Dam:_______________________________________________________AKC # :________________________

Breeders name: _______________________ Breeders address: ________________________________________

City: _______________________________ State: ____________________ Zip: __________________________

I enclose $ ______________ for the litter nomination in Region _____________________

SEND FORMS TO: Name: ______________________ Address: ______________________________________

City: _______________________________ State: ____________________ Zip: __________________________

Quantity: ________ Signed: ___________________________________ Tel. No.: _________________________
_________________________________________________________________________________________

Juvenile Litter Questionaire Litter # ___________
(MUST ACCOMPANY FUTURITY NOMINATION FORM)

Sire:__________________________________ AKC #:________________________OFA Cert. __ Yes __ No

Dam:_________________________________AKC # :________________________OFA Cert. __ Yes __ No

TOTAL NUMBER OF PUPS ________ Males: _______Females:_______

Still born: Male: ____ Female: ____ Died within 3 weeks: Male:____ Female: ____

Color code:

Sable = S;

Black & Tan = B/T;

B1 color = B1C;

Blue = Blue;

Brown = LV

Males: 1____ 2____3____ 4 ____ 5 ____ 6____ 7____ 8____

Females: 1____ 2____3____ 4 ____ 5 ____ 6____ 7____ 8____
_____________________________________________________________

Litter Characteristics
(Leave blank unless applicable)

Health Characteristics
Heart: (Ask Vet for diagnosis - see
BLUE BOOK II for articles)

LONG COATS:

M: __ F: __

FADING PUPPIES:

M: __ F: __

MURMUR:

M: __ F: __

MONORCHID:

M: __ F: __

CRYPTORCHID MALES:

M: __ F: __

PDA:

M: __ F: __

UMBILICAL HERNIAS:

M: __ F: __

CLEFT PALATES:

M: __ F: __

PRAA:

M: __ F: __

DWARFISM:

M: __ F: __

CARPAL SYNDROME PASTERNS:

M: __ F: __

SAS:

M: __ F: __

UNDERSHOT BITE:

M: __ F: __

OVERSHOT BITE:

M: __ F: __

LEVEL BITE:

M: __ F: __

WRY (TWISTED )BITE:

M: __ F: __

OTHER: (Please Specify:)_______
____________________________

ANKYLOSIS:

M: __ F: __

SEIZURES:

M: __ F: __

Band around esophagus due to PRAA:

ESOPHAGEL: (Ask vet for diagnosis - See BLUE BOOK II for articles)

Dilation or "Ballooning" of the esophagus

:M: __ F: __

List three outstanding qualities of this litter:
1. ____________________________2.____________________________3.____________________________

Particular Problems (Structure, Gait, Temperament______________________________________________________________________________

REGION # 1 NORTHEASTERN - Maine, Vermont, Massachusetts, New Hampshire, New York, Rhode Island, Connecticut -

REGION # 2 MID-ATLANTIC -New Jersey, Delaware, West Virginia, Pennsylvania, Maryland, Virginia. -

REGION # 3 SOUTHEASTERN - North Carolina, Tennessee, Mississppi, Georgia, South Carolina, Louisiana, Alabama, Florida, Puerto Rico -

REGION # 4 GREAT LAKES - Michigan, Ohio, Indiana, Kentucky -

REGION # 5 MIDWESTERN - Wisconsin, Missouri, Illinois, Iowa, Mnnesota -

REGION # 6 SOUTHWESTERN - Texas, Oklahoma, Nebraska, Arkansas, Kansas, Colorado, New Mexico -

REGION # 7 SOUTHERN PACIFIC - Arizona, Las Vegas, Nevada, *Southern California (all counties south of San Luis Obispo; Kern & San Bernardino)-

REGION # 8 MID-PACIFIC Nevada(Except Las Vegas), Utah, Northern California (all counties north of San Luis Obispo; Kern & San Bernardino) -

REGION # 9 NORTHWESTERN - Washington, Idaho, Wyoming, South Dakota, Oregon, Montana, North Dakota, Alaska, all of Canada -

Mail form to:

JIM RAU DOG SHOWS, LTD., PO BOX 6898, READING, PA 19610,
PHONE:610-376-1880; FAX: 610-376-4939