GERMAN SHEPHERD DOG ADVISORY COUNCIL (INC.)
NEW ZEALAND
MEMBER OF THE WUSV
STRUCTURAL ASSESSMENT
ENTRY FORM
GSDAC Structural Assessment Registrar
Mr Bruce Anderson
PO Box 127
Bay View
Napier 4149 Ph 06 8366946
I wish to enter the GSD described on this form into the GSDAC Structural Assessment to be held on
(date)
/
/ 20
at (place)
Full name of GSD (The GSD need not be registered with NZKC but should be a purebred GSD
Dog / Bitch
Date of Birth
NZKC Reg. No.
Titles / Qualifications
Hip Scores
Elbow Scores
Tattoo / Microchip Number
Certified by (please circle)
BVA / GSDCA / NZVA / SV / WA
Paternal Grandsire
Sire
Paternal Granddam
Maternal Grandsire
Dam
Maternal Granddam
Breeder/s Name
Breeder/s Area
Owner/s Name
Owner/s Address
Signature
GSDAC Memb. No.
Please check 2 weeks before event date that your entry has been received.
Office Use
$15 Entry Fee Received by Structural Assessment Registrar _____ / _____ / __20____
Signature ____________________________
Certificate No.
Issued on _____ / _____ / __20____
STRUCTURAL ASSESSMENT APPLICATION
OCTOBER 2014