ASCA Agility – It’s for All-Breeds!
ASCA Service Membership and Tracking Number Form
Beginning
1/1/2003 for non-ASCA registered dogs – In order to have
ASCA qualifying legs tracked and to receive ASCA titling certificates, each non-ASCA registered dog will be required to have
an ASCA Tracking Number. This is a one-time fee of $10/dog. At the time of applying for the tracking number, the
individual owner must also be an ASCA member (minimum membership type of ‘Service’ is required). ASCA membership
does not need to be maintained in subsequent years. It will be the responsibility of
the owner to identify to ASCA the shows and legs earned when applying for a Tracking Number for those ASCA qualifying legs
earned from 1/1/2003 until submission of application. Please attach a listing
of scores, trial dates, etc. received at ASCA or dual sanctioned trials that you would earned prior to applying for a tracking
number.
Please
type or print clearly. Incomplete or illegible forms will be returned.
Membership
Application:
Owner’s Name (1)_________________________________________________
Owner’s Name (2)_________________________________________________
Owner’s Address: _________________________________________________
City, State, Postal Code:____________________________________________
Phone Number: _______________________E-Mail:______________________
Type of Membership: □ Service ($8) This form for Service Membership only. If you
would
like to become a full member use the official ASCA Membership Application.
Application
Type: □ New □ Renewal □ Existing Member Mem.# _____________
I
(We) agree to abide by the ASCA Articles of Incorporation, Bylaws, and all ASCA Rules and Regulations governing the ASCA Registry
and all other ASCA programs.
Owner’s
Signature
(1):__________________________________________________________
Owner’s
Signature (2):__________________________________________________________
Dog
Information: Lifetime fee for tracking number is $10.00 per dog for ASCA Members
Dog’s
Full Name: _________________________________________________________________
Dog’s
Call Name: _________________________________________________________________
Any/All
Previous Registration Numbers Used: _____________________________
__________________________________________________________________
Sex:
______________________ Birthdate: _______________________________
Breed:________________________________
Mail completed form with check or money order to:
ASCA Business Office
6091 E. State Hwy 21, Bryan, TX 77808
Phone: 979-778-1082
