test 3 - German Shepherd Dog Club of America

Person filling out the form:

First Name *

Last Name *

Email Address *

Dog's Information:

Dog's Full AKC Registered Name *

AKC Titles Earned

Other Titles Earned

OFA Certification Numbers

Date of Birth

Date of Death

Please provide a link to an online pedigree

Breeder's Name(s) *

Owner's Information

Owner's Name(s) *

Owners Address, where your plaque will be mailed. We cannot mail to PO Boxes, please provide a valid street address. Plaques will be mailed next year before the 2026 National.

Owner's Street Address

Owner's City & State / Province / Region

Owner's Zip / Postal Code

Owner's Country

Owners' Phone *

Owner's Email Address *

Owners who are members of GSDCA *

Please Upload a photo of this sire/dam

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Please Upload a copy of this dog's AKC Registration

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Please Upload a copy of Pedigree and AKC Titles earned

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Please Upload a copy of this dog's OFA Certificates

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Person filling out the form:

Dog's Information:

Owner's Information

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