CGC Information Form

September 10, 2011

2:00-3:00 testing

Buckeye Woods Park

6335 Wedgewood Road, Medina Ohio 44256

Please print and bring this form the day of the testing. You will receive an official form to send in after testing.

CGC testing for all breeds..............................first come.... first tested. Please sign in.

given by :

Perfect Pooches Dog Training LTD

Margie Duplaga

330-321-1820

E-Mail: Margie@PerfectPoochesDogTraining.com

Amount Paid by Paypal:___________test ($16)             _________test and medallion($27)

Amount Paid by Mail: _____________test ($15)             _________test and medallion ($25)

(payable to Margie Duplaga)

Please order a medallion for me and mail to the below location at an additional cost of $15

($10 for medallion and $5 for shipping) payable to Margie Duplaga the day of the picnic

Medallions must be ordered by August 10 to receive the day of the picnic.

Name________________________________________________________________________________________

Address______________________________________________________________________________________

____________________________________________________________________________________

Email________________________________________________________________________________________

Phone_______________________________________________________________________________________

Dog's Full Name______________________________________________________________________________

AKC#________________________________________________________________________________________

please bring a buckle or martingale collar,

proof of ownership,

AKC number

and this form

Testing is $16 / AKC medallion is $10 / **you will also pay a $10 filing

fee by check which you will send in with the paperwork after testing

If you would like a medallion you must register and pay by August 10th.

You may order a medallion the day of the test and there will be an

additional charge for mailing it to you.

You may pay by Paypal or by mail to: 

Mastiff Picnic CGC testing

424 ROBINWOOD AVENUE

WHITEHALL, OHIO 43213