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AGILITY DOG ASSOCIATION
OF AUSTRALIA LTD
ABN 83 070 415
404
ONLINE TITLE APPLICATION FORM
- CONGRATULATIONS!
Fill out the
following details, submit your form (click submit button at end of
page), and then print two copies of the confirmation page - one
for your records and one to send to ADAA with your payment and
your Clear Round or Qualifying Certificates.
The applicant/member has read and understands the refund policy which is
available at
http://www.adaa.com.au/_policies/POL-FIN-13-Refund-Policy-080124.pdf
and by lodging the form, the applicant/member agrees with and is bound by
the refund policy.
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YOUR DOGS DETAILS (use NA for Junior Handler Awards) |
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NAME OF DOG:
DOG ADAA Registration No:
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DOGS RESISTERED OWNER(S)
DETAILS
or JUNIOR HANDLER DETAILS |
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SURNAME:
FIRST NAME: |
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MEMBERSHIP NO :
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SURNAME:
FIRST NAME: |
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MEMBERSHIP NO:
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ADDRESS:
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SUBURB / TOWN:
STATE:
POSTCODE:
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PHONE:
Home
Mobile
Work
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EMAIL ADDRESS:
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Title Applied For:
>
(eg: AAD, R-AAD, AAGD etc)
< Is this a MAAD or AAC? If so, it would be great if you could
send a photo of your dog to
ADAA for our records (and our
website Hall of Fame) - Thanks!
All owners must be financial members of the Agility Dog Association of
Australia Ltd (ADAA) before any dog is entered an an Agility
Test/Event. Failure to comply with the Regulation may result in the forfeit
of all results/certificates gained by the dog and refusal of the
application.
Please select from the following (note:
MAAD1, MAAD2, AAGD2 etc are certificate only, all other titles have the
option of a rosette and certificate):
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I would like our
Title as: |
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I would like a Title
Badge: |
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Badge Colour
(International Titles ONLY): |
< Please indicate the colour if you selected a badge. Regular /
Junior colours above. |
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Postage: |
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In the fields below, please enter in order MOST RECENT to OLDEST, details
of the Clear Round and/or Qualifying Certificates. All Clear
Round and/or Qualifying Certificates MUST BE MAILED TO ADAA (with a copy of
the confirmation of this form). Title Certificates will not be issued
without receipt of Certificates. They will be returned with Titles.
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#1:
DATE:
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Affiliate (Club):
Handler:
Judge:
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Competition Standard:
Class:
Test / Event:
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#2:
DATE:
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Affiliate (Club):
Handler:
Judge:
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Competition Standard:
Class:
Test / Event:
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I'm finished, skip all remaining fields
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#3:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#4:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#5:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#6:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#7:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#8:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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#9:
DATE: |
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Affiliate (Club):
Handler:
Judge: |
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Competition Standard:
Class: Test / Event: |
I'm finished, skip all remaining fields
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skip |
TO SUBMIT THIS FORM click on the
'Submit' button at the end of this page.
Please check the information you
have provided above thoroughly before submitting your application -
thanks. When you submit this
form you will be taken to a page to confirm the submission was successful.
Here you will be able to print a copy for your records and to forward to
ADAA with your payment along with your Clear Round / Qualifying
Certificates.
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Your details will be on record as
soon as this form is submitted.
Please allow 14 days after
receipt of payment for processing of
Title Applications. Any enquiries should be made a minimum of 21 days after
dispatch of Applications.
Cheques / Money Orders should be made payable
to:
AGILITY DOG ASSOCIATION OF AUSTRALIA LTD
Cheques / Money Orders and a
printed copy of this form (print version appears after you select 'Submit') should
be sent to:
THE
SECRETARY
AGILITY
DOG ASSOCIATION OF AUSTRALIA
LTD
PO Box 2212
Gailes Qld 4300
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Before submitting double check that the details you have provided are
correct - thanks. |