P.O. Box 177, Warner,
Phone: 603-456-2350 Fax: 603-456-2286
FOR GDC USE:
GDC is a
Non-profit, Tax-exempt organization.
EYE EVALUATION and REGISTRATION
This application may be copied to your printer or obtained by mail or fax from GDC:
|OPHTHALMOLOGIST'S NAME, Please Print
||NUMBER IN LITTER
|K.C. Registration No.
||FAX or E-Mail:
|Sire's Registered Name
|| K.C. Regis.
|Dam's Registered Name
Fee included (payable to GDC) $ ______
No charge for Affected Entries
I hereby certify that the data submitted is of the dog
described on this application. I am aware that the data will be public
information and will be maintained for the purpose of improving the breed and
lowering the risk of genetic diseases, as well as for research purposes.
Institute for Genetic Disease Control in Animals / Revised 10/02