Vaccination Record - Dog

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V
R
D
 
ACCINATION 
ECORD 
 
OG
 
 
 
E
N
:   
 
 
 
 
C
N
:
  
 
 
 
 
XHIBITOR
AME
LUB 
AME
  
#1
C
N
:   
 
 
 
#2
C
N
:   
 
 
 
 
 
ANINE
AME
 
ANINE
AME
 
 
Vaccination 
** Rabies 
Bordetella 
Distemper
Parvo 
Hepatitis
Para‐
*Corona 
*Leptosprosis
Kennel Cough 
Virus 
Influenza 
   Virus 
Dog #1 
 
 
 
 
 
 
 
 
Dates 
Dog #2 
 
 
 
 
 
 
 
 
Dates 
 
Vaccination Record – REQUIRED 
Note: Attach a copy of your veterinarians signed rabies certificate. You will not be able to show if you do 
not have a current Rabies Certificate or Vaccination Record. * Optional unless State Vet Declares 
outbreak in our area. 
 
S:\4H\FAIR\Fair 2010\Fair Entry Forms\Dog\10DogVaccinationRecord.doc
 
 
V
R
D
 
ACCINATION 
ECORD 
 
OG
 
 
E
N
:   
 
 
 
 
C
N
:
  
 
 
 
 
XHIBITOR
AME
LUB 
AME
  
#1
C
N
:   
 
 
 
 
#2
C
N
:   
 
 
 
 
ANINE
AME
 
ANINE
AME
 
 
Vaccination 
** Rabies 
Bordetella 
Distemper
Parvo 
Hepatitis
Para‐
*Corona
*Leptosprosis
Kennel Cough 
Virus 
Influenza 
   Virus 
Dog #1 
 
 
 
 
 
 
 
 
Dates 
Dog #2 
 
 
 
 
 
 
 
 
Dates 
 
 
Vaccination Record – REQUIRED 
Note: Attach a copy of your veterinarians signed rabies certificate. You will not be able to show if you do 
not have a current Rabies Certificate or Vaccination Record. * Optional unless State Vet Declares 
outbreak in our area. 
 
 
S:\4H\FAIR\Fair 2010\Fair Entry Forms\Dog\10DogVaccinationRecord.doc
 

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