Owner Name:

Owner Surname:

Handled by: Handled by: Owner handler Alternative handler

Handler Name:

Handler Surname:

Cell Phone number:

Email address:

NFTA Affiliated Home Club: NFTA Affiliated Home Club:Border Field Trial ClubCentral Field Trial ClubGSP Gauteng ClubKZN Field Trial ClubNatal Field Trial ClubOverberg HPR Field Trial ClubWestern Cape Field Trial Club

Select to indicate number of dogs entered: Select to indicate number of dogs entered: Dog 1 Dog 2 Dog 3 Dog 4

Call Name Dog 1:

Registered Name Dog 1:

NFTA No Dog 1:

Breed Dog 1:

Whelp Date Dog 1: (YYYY/MM/DD)

Gender Dog 1: Gender Dog 1: Dog Bitch

Colour Dog 1:

Sire Dog 1:

Dam Dog 1:

Call Name Dog 2:

Registered Name Dog 2:

NFTA No Dog 2:

Breed Dog 2:

Whelp Date Dog 2: (YYYY/MM/DD)

Gender Dog 2: Gender Dog 2: Dog Bitch

Colour Dog 2:

Sire Dog 2:

Dam Dog 2:

Call Name Dog 3:

Registered Name Dog 3:

NFTA No Dog 3:

Breed Dog 3:

Whelp Date Dog 3: (YYYY/MM/DD)

Gender Dog 3: Gender Dog 3: Dog Bitch

Colour Dog 3:

Sire Dog 3:

Dam Dog 3:

Call Name Dog 4:

Registered Name Dog 4:

NFTA No Dog 4:

Breed Dog 4:

Whelp Date Dog 4: (YYYY/MM/DD)

Gender Dog 4: Gender Dog 4: Dog Bitch

Colour Dog 4:

Sire Dog 4:

Dam Dog 4:

Stakes Entered for Dog 1: Stakes Entered for Dog 1: Derby Stake R250 Maiden Stake R400 Open Stake R400

Stakes Entered for Dog 2: Stakes Entered for Dog 2: Derby Stake R250 Maiden Stake R400 Open Stake R400

Stakes Entered for Dog 3: Stakes Entered for Dog 3: Derby Stake R250 Maiden Stake R400 Open Stake R400

Stakes Entered for Dog 4: Stakes Entered for Dog 4: Derby Stake R250 Maiden Stake R400 Open Stake R400

Total = For all Stakes entered

Method of Payment: Method of Payment: EFT / Transfer to our bank account Credit card payment via YOKO (Link will be messaged to you)