Central Valley ASC

Merit Program Points Reporting Form

Please submit completed form to the Merit Program Secretary no later than 1/5/08

Registered Name of Dog:_______________________________________________________________________________

ASCA Registration Number: ________________ Sex:______ Date of Birth:___________________ Altered?: Yes No

Owner the date points were earned:_______________________________________________________________________

Phone Number or Email:________________________________________________________________________________

Junior handler (for Juniors points only):____________________________________________ Age at Show:__________

Please fill out the following information for each area of competition this dog has earned merit points. Use one form for each show or trial where points were earned. For conformation events where the dog has won WD, WB, enter the total number of dogs/bitches defeated. If BOW or BOB please enter the numbers for the opposite sex as well as for the same sex.. Class placements need only enter the number defeated in the class.

Conformation Class Entered	Placements Earned	Number of Dogs/Bitches Defeated in Class	Total Class Dogs Defeated	Total Class Bitches Defeated	Specials Entered
Conformation Class Entered	Placements Earned	Number of Dogs/Bitches Defeated in Class	Total Class Dogs Defeated	Total Class Bitches Defeated	Dogs	Bitches

Show Date	Obedience Class Entered	Placement and Score Earned	Show Date	Working Trial Class Entered	Placement and Score Earned

Show Date	Agility Class Entered	Placement and Qual. Score	Show Date	Agility Class Entered	Placement and Qual Score

Show

Date

Class Entered

Placements

(Class, RJH, BJH)

Total Juniors Defeated

Name of club hosting this show:____________________________________________________________

Show Secretary:_____________________________________________ Date:______________________

Submit this form to: Denise Sharp 12666 Rd. 23, Madera, Ca. 93637 Email: skedadle@integrate.com