I am applying for a NAWBA Scorebook and guarantee that the information listed below is correct.

Dog’s Name: ______________________________________Whelp Date: ____/ ____/ ____ (dd/mm/yy)

Breed: __Bouvier__ Color: _________________ Sex: ____ dog ___ bitch Spay/Neuter ___ yes ___no

Registration Number: __________________ Breeder’s Name: ________________________________

Tattoo Number: ______________________Microchip: ______________________________________

Dog’s Sire: _____________________________________Registration Number: __________________

Dog’s Dam: ___________________________ ________Registration Number: ___________________

Owner’s Name: ______________________________________________________________________

Owner’s Address: _____________________________________________________________________

Handler’s Name: ______________________________________________________________________

Handler’s Address: ____________________________________________________________________

If the dog has any former degrees, a copy of the scorebook

Must be sent with this application form.

I hereby certify that the above information is correct and that the owner and handler are current members

in good standing of the North American Working Bouvier Association.

Owner/Handler Signature: __________________________________ Date: _____________________

Include with this form:

1) A copy of the bouvier’s registration papers

2) A minimum three generation pedigree

3) A color conformation and front view picture of the bouvier (need not be professional)

4) A copy of the dog’s former scorebook (if applicable)

5) $10 US fee (checks payable to NAWBA

Send Information to:

Carol Walker, NAWBA Scorebook Chair Questions:

4363 Pueblo Trail E-Mail: bouvier90@woh.rr.com

Jamestown Ohio 45335 Phone: 937-675-9077