Litter Referral Application Form

Litter Referral Application Form

BMDCR breeders many apply for breeder referral services and litter box advertisements on line by filling out the form below. You will receive conformation of you application by e-mail.

First Name: Last Name:

Street:

City: State: Zip:

E-Mail:

Phone: Approximate Whelp Date:

Breeder Referral Litter Box Ad

Are you a BMDCR voting member in good standing?	Y N
Have you paid the yearly $5.00 referral fee?	Y N
Are both the sire and dam registrable with the AKC?	Y N
Have both the sire and dam been evaluated by either the OFA or GDC for both hip and elbow dysplasia?	Y N
Are both the sire and dam over 18 months of age?	Y N
Will the puppies be sold with a health guarantee subject to a veterinarian's exam within 48 hours of sale?	Y N
Are both the sire and dam entered in the Berner-Garde?	Y N
Will you provide a complete litter entry to the Berner-Garde?	Y N

	SIRE	DAM
.AKC Name
Reg. No
Born
*Hip No.
*Elbow No.

* Hip and elbow numbers are not required to list a litter

Philip Shaffer, pshaffer@bmd.org last update 2/7/05
Bernese Mountain Dog Club of the Rockies