Beauceron Pedigree Database
Submit Dog Information

* Fields in Red Are Required Fields

* Purpose for submission:  New Dog    Change or Correction

Note: If this is a Change to a dog already in the datatbase, only fill in the Required (red) fields and the additional information. You do not need to fill out the entire form.

* Your name:

* Your Email Address:

* Dog's full registered name (do not include titles)
If this is a Change, please enter dog's name exactly as it appears in the database

* Gender:  Male (Male)     Female (Femelle)

* Color:    Blk/Rust (Noi. Mar. Fau)    Harlequin (Arlequin)    Blue    Red    Other

Registration Number - please include if dog is registered (ex. LOF, LOSH, NHSB, AKC, etc.)

Registration Country

Registration Number 2 - if registered in another country (ex. LOF, LOSH, NHSB, AKC, etc.)

Country where dog was born (only if different from above)

Country where dog resides (only if different from above)

Dog's call name (dit, dite)

Titles which PRECEDE this dog's name (ex. CH Lux, CHCS, OTCH). Please put in ALL titles each time.

Titles which FOLLOW this dog's name (ex. Brevet Ring, CD, HS, AX). Please put in ALL titles each time.

Identification (Tattoo/Chip)

Date of birth (DD/Mon/YYYY format 27 January 2012)

January February March April May June July August September October November December

FRENCH Cotation (issued by Scc and CAB)

None (1) Confirme (2) 1er Choix (3) Excellent (4) Recommande (5) Elite B (6) Elite A

Year Cotation Rating Earned

Cotation Rating from any other country besides France

Country Where Other Rating was Earned

Breeder LAST Name (producteur nom)

Breeder First Name (producteur prenom)

Owner LAST Name (proprietaire nom)

Owner First Name (proprietaire prenom)

Pedigree: If this is a new dog, you MUST include the Sire (pere) & Dam (mere). Please list the Sire and Dam exactly as they appear in the database. Do not include titles. If the Sire and/or Dam are not already in the database, you must fill out a separate form for the Sire and/or Dam.

Sire:(M-pere)

Dam:(F-mere)

Health Certifications:

Hip Rating (ex. Dys A/A, OFA Good, HD A/B)

Elbow Rating (ex. AD 0/1, OFA Normal, OD 1, ua)

CERF # (Eye Certification)

Heart Rating (Cardiac Certification)

Thyroid Rating (Thyroid Certification)

Back Rating (Back Xray Certification)

Dentition (Teeth)

DNA (DNA Marker)

Other Health Certifications

If this is a change, please specify what changed for this dog (ex. New Owner, Added Registration #, New Titles).
Also include any other information about this dog.

Verification Process

The following verification is used to make sure you are a human visitor and to prevent spam submissions.

Enter the two words as best you can.
Both words do not have to be correct to continue.

Please make sure you have included all * Required fields.

This submission is for BEAUCERONS ONLY.