Dog's Registered Name (required)

Dog's Call Name (required)

AKC Registration Number (required)

Sire

Dam

Breeder(s)

Owner/Co-Owner (required)

Address (required)

Phone number (required)

Email address (required)

GCA Member?
YesNo

1) Level 3 Versatile Champion award -- list date awarded

2) Choose one
Conformation excellenceRunning excellenceAgility, Obedience, Rally, Tracking, Scent Work. or Barn Hunt Excellence

Enter award earned and date

Upload documentation for non-AKC title (2 MB or smaller)

Upload photo of dog for GCA's Facebook page and website (2 MB or smaller)

Enter text to be used in GCA Newsletter -- 50 words maximum (free for GCA members)

Check if all data is correct? --

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