Marilyn Clayton, CCC ROM(X) Committee, ALL INCOMPLETE APPLICATIONS WILL BE RETURNED. A REAPPLICATION FEE OF $5.00 IS REQUIRED WITH EACH RESUBMISSION. PHOTOS MAY BE SUBMITTED ELECTRONICALLY. |
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COLLIE CLUB OF CANADAAPPLICATION FOR A REGISTER OF MERITAPPLICANT’S NAME: _________________________________________________________ ADDRESS: __________________________________________________________________ CITY & PROVINCE: ___________________________________________________________ POSTAL CODE: ______________ TELEPHONE: __________________________________ FAX: _____________________ EMAIL: ___________________________________________
THE APPLICANT MUST BE A LEGAL OWNER OF THE ROM/ROMX CANDIDATE. THE CANDIDATE MUST BE THE SIRE/DAM OF ALL LISTED TITLEHOLDERS.
DOG’S NAME: ________________________________________________________________ CKC NO: ___________________ SEX: ________ VARIETY: ___________________________ COLOUR: ___________________________ BIRTHDATE: _______________________ BREEDER: __________________________________________________________________ SIRE:_______________________________________________________________________ CKC NO: _________________ VARIETY: __________________________ DAM:________________________________________________________________________ CKC NO: _________________ VARIETY: __________________________
____________________________________________________________________________ Applicant Signature and Date
For each titled offspring the following must be submitted on a separate sheet of paper: Name; CKC/AKC/Foreign Reg.No.; Sex; Variety; Colour; the Name & CKC/AKC/Foreign Reg.No. of the offspring’s non-applying sire/dam; list of titles and dates each title was earned. For all CKC titles please include either a copy of the certificate OR the issue, date and page where the title is published in the CKC on-line results. For all non-CKC titles please include (1) a copy of the certificate OR test sheet that includes the testers name and signature, date & location AND, (2) if a progeny is not CKC-titled, a copy of the progeny’s registration certificate confirming sire and dam. Fees for each application are $10.00 for CCC Members and $25.00 for nonmembers. Fees are non-refundable and must accompany this application. ROM and ROMX titles are considered separate applications unless submitted at the same time. Make cheques and money orders payable to the COLLIE CLUB OF CANADA. Incomplete applications will be returned & a reapplication fee of $5.00 is required for each resubmission. Please also include a 3-generation pedigree and photo of the candidate for our files & website. Send the completed application, required documentation, fees, pedigree and photo to: MARILYN CLAYTON, CCC ROM(X) Committee |
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