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BREEDER REFERRAL DIRECTORY eFORM - BCSA MEMBERS ONLY
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Complete the form below to be included in the BCSA Breeder Directory.  Review your information carefully before pressing "Submit Info".   (R) = Required Information

DO NOT COMPLETE FORM UNLESS YOU HAVE A NEW LISTING OR HAVE CHANGES TO YOUR CURRENT LISTING.

 
This form is for BCSA members only. 
 Add or Update:   (R)
   
Are you a
BCSA Member?:
  (R)
If you answered NO to the question above, STOP and go to the Membership page.
Your information will not be processed unless you are a BCSA member.
   
First Name: (R)
Last Name: (R)
City/State/Zip: (R)                     (R)                    (R)
Telephone: (R) 
E-mail:
Confirm E-mail:
Kennel Name (if applicable)
Kennel Web Site:
   
Select all that apply:
Adult Dogs Puppies Stud Service
Other (please specify):
   
Select Activities:
Agility Conformation Flyball Freestyle Herding
Obedience Rally Therapy Tracking Search/Rescue
Service Dog Other (please specify below):
   
Health (routinely performed)
testing/certifications:
Hips Elbows Eyes Thyroid
Other (please specify):