2011  Awards Order Form

(please submit to Joan Telfer by January 5, 2012)

Engraved plaque $10 (includes dog's call name)______

Engraved plaque with dog's registered name  is an additional 15 cents per letter (for the registered name)._______

Paper Certificate Free_____

TD_____ TDX _____ VST _____CT _____

Handler's Name____________________________________________

Address_____________________________State___________Zip______

Phone___________________

Dog's call name___________________________________________

Registered name___________________________________________

One form for each dog please, Thanks!

Comments on passing track:

Send to Joan Telfer, 13030 30th St N., Stillwater MN 55082

Total enclosed ___________