Parade of Title Holders Form - 2015 FSSA National Specialty

Parade of Titleholders
2015 FSSA National Specialty
Deadline is March 23, 2015
Name: ________________________________________________________________
Address: ______________________________________________________________
E-Mail: ________________________________________________________________
Dog’s Name: ____________________________________________________________
(Only AKC Titles can be included)
Call Name: _______________________DOB: _________________
Sire:____________________________________________________________________
Dam: ___________________________________________________________________
Breeder: _________________________________________________________________
Owner: __________________________________________________________________
Please include a photo and a 75 word or less statement about your
Legend to be included in a commemorative catalog
Cost: _____ $26 (Parade Catalog picked up at National)
_____ $31 (Parade Catalog Mailed)
______ Check enclosed
______ Pay Pal (add 2%) PayPal email address is
[email protected]
Return this form by March 23, 1015 with a photo and statement of the honoree to:
If Paying by check, send Check (Payable to FSSA) along with this Form to:
Lori Carver 18 Plainfield Road, Cummington, MA 01026.
If Paying by PayPal, email Pay Pal Receipt and this form to:
Linda Blaser at [email protected] & Lori Carver at [email protected]
(Remember to add 2% PayPal Fee)