Litter Referral Application Form

Breeder Referral Application

Breeders many apply for breeder referral service on line by filling out the form below. You will receive conformation of your application by e-mail.

Name:

E-Mail:

Phone: Approximate Whelp Date:

Are you a BMDCR voting member in good standing?	Y N
Have you paid a yearly $5.00 referral fee to the BMDCR?	Y N
Are both the sire and dam registrable with the AKC?	Y N
Have both the sire and dam been evaluated by the OFA 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

Philip Shaffer, pshaffer@bmd.org last update 11/23/13