Blue Ribbon Litter Application

Name

Address

City & State

Zip Code

Telephone

E-mail

Website

Kennel name

Date of Birth:

Registered name of Sire:

Sires date of birth:

Sires ACC registration number:

Has this Sire had a CERF certification in the last 24 months? Please list his CERF number:

Please enter the OFA web site link to this Sires health certifications at OFA:

Please check which five (5) Health tests are being submitted for this Sire:
CERF
OFA Patella
OFA Cardiac
OFA Thyroid
OFA or Pennhip Hips
OFA Elbows
CMR
vWD
Neonatal Ataxia
Blood panel

Registered name of Dam:

Dams date of birth:

Dams ACC registration number:

Has this Dam had a CERF certification in the last 24 months? Please list her CERF number:

Please enter the OFA web site link to this Dams health certifications at OFA:

Please check which five (5) Health tests are being submitted for this Dam:
CERF
OFA Patella
OFA Cardiac
OFA Thyroid
OFA or Pennhip Hips
OFA Elbows
CMR
vWD
Neonatal Ataxia
Blood panel

If you have Blood Chemistry panels, DNA test certification for CMR, von Willdebrand's or Neonatal Ataxia, please submit a copy of your original certificate via facsimile, e-Mail or regular postal mail. Only copies of original certificates from the testing facility will be accepted. Copies of emails from testing facilities are not acceptable.
After reviewing the Health Data for the parents of the proposed Blue Ribbon Litter, a member of the ACC Health Committee will respond and advise you of your acceptance. If approved, you will receive a confirmation e-Mail along with the approved ACC Blue Ribbon Litter graphic which must be used for the duration of time you advertise this special litter of Coton puppies. The graphic must contain a link back to the ACC Blue Ribbon Litter Program website page.
We thank you for your commitment to the ongoing health of our wonderful breed!!!
In submitting this application for a Blue Ribbon Litter Award, I agree to only use the Blue Ribbon Litter (BRL) graphic inconjunction with the litter it is being assigned to. I further agree to remove the graphic after this litter has been placed, or at any time an ACC representative requests me to do so.