Performance Events Department

Flyball Application Form

Effective July 1, 2012 the AKC will begin recording titles earned in North American Association (NAFA) events. When a earns the title of Flyball Champion (FDCh), Flyball Master (FM), or the ONYX title the owner may submit this completed application along with a copy of the NAFA title certificate plus a $20.00 recording fee and AKC will place the title on the dog’s record and it will appear on the dog’s pedigree. No AKC title certificate will be issued unless ordered through the use of this form for a fee of $10. Ordering a title certificate is at the discretion of the owner. Higher level titles will supersede any previously recorded. For example, FM will supersede FDCh on a dog’s pedigree. The AKC will record titles issued back to January 1, 2000. Please keep a copy of this form for your records.

Owner Name: ______

Address: ______

Telephone: ______Email: ______

Dog Name: ______

AKC Reg. Number: ______Breed: ______

NAFA Title to be Recorded: ______Date Earned: ______

With a new title, would you like an updated AKC Pedigree? 3 Generation Pedigree w/ Title: $25.00 4 Generation Pedigree w/ Title: $32.00 Fee included: Record Title Only: $20.00 Title Certificate: $10.00 (optional) Pedigree: $ (optional)

Total amount submitted: $______

Payment method: Check Enclosed (made payable to American ) ______

Credit Card #: ______Exp. Date: ______

Printed Name of Cardholder: ______

Signature: ______

Submit to: AKC Performance Events Attn: PE Titles E-mail: [email protected] 8051 Arco Corporate Drive, Suite 100 Raleigh, NC 27617-3390 FAX: (919) 816-3905

This form can be found on the AKC website: www.akc.org/pdfs/events/performance/Flyball_Title_Application_Form.pdf