Farm Dog Certified Title Application Form
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1Performance Events Department
F
D
C
T
A
ARM
OG
ERTIFIED
ITLE
PPLICATION
If a dog passes the Farm Dog Certified Test on two occasions under two different judges, the owner may apply for the
suffix Farm Dog Certified (FDC) title by submitting this title application form. Applying for the title is up to the
discretion of the owner. To apply an owner must submit this completed form along with a $20 recording fee. Upon
verification, the title will be recorded on a dog’s record, a title certificate issued and the title will appear on a dog’s
pedigree. Please be aware that event superintendents /secretaries may, but are not required to, include the FDC title in
event catalogs. Please note that the date appearing on the title certificate will be the most recent date listed below.
Owner Name: _____________________________________________________________________
Address: _________________________________________________________________________
_________________________________________________________________________________
Phone: _______________________________ Email: _____________________________________
Dog’s Registered Name: _____________________________________________________________
AKC Reg. or Canine Partners Listing #: _______________________ Breed:____________________
Please provide two qualifying tests:
1. _______ ___________________________________ ________________ ___________________
Date
Club Name
Event #
Location
2. _______ ___________________________________ ________________ ___________________
Date
Club Name
Event #
Location
Please enclose payment: $20.00
Credit Card Payment Info:
Cardholder Name: ____________________________________________________________
Credit Card Number: _________________________________Exp. Date: _______________
Signature Authorization for $20 charge:____________________________________________
Check or Money Order made payable to the American Kennel Club
(
Mail to: AKC Performance Events Dept.
Fax:
919) 816-3905
Attn: FDC Title
Email:
8051 Arco Corporate Drive, Suite 100
Telephone: (919) 816-3908
Raleigh, NC 27617
This form can be downloaded from:
Go to “Events” then “Downloadable Forms” then “Other Helpful Performance Forms”
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Parent category: Business