Breeder Referral Litter Listing

This form is to be used to submit an expected litter to the PWDCA Breeders with Puppies List. It is intended for use by participating breeders in the PWDCA Breeder Referral Program.

Here are instructions to help you along:

Please enter all information as submitter and for the Sire and Dam.
All fields have ample room for your information. Don't be concerned about truncating any information.
Tabbing between fields is recommended to facilitate navigating the form.
Do not hit the ENTER key until the form is completed. WAIT until you finish and review before “clicking” on SUBMIT
Be prepared to complete your entry before starting.
When you SUBMIT the form, a copy of your data will be Emailed to you as confirmation of delivery.
Include your Email address (required).
There is a checkbox to indicate if your submission is an update or correction to a prior submission. Check it, if appropriate.

For information about the PWDCA Breeder Referral Program, please contact the Breeder Referral Services Coordinator:

Sandy Overton
1395 SE 8th Ave.
Oak Harbor WA 98277

Email: referral@pwdca.org
Phone: 360-675-9539
Fax: 360-240-0292

Breeder Referral Litter Listing Form

SUBMITTED BY
Your Name
Address
City
State
Zip
Telephone #
Email Address	(Required)
Kennel Name
Correction?	Check here if this is a correction to a previously submitted registration
Whelping date: Actual or Expected	(MM/DD/YYYY or MM/YYYY)
(An expected litter will be listed no sooner than four weeks PRIOR to the expected whelping date.)

SIRE
Name of Sire
GM-1
OFA	(hips) (elbows)
CERF
Date of last CERF exam	(MM/DD/YYYY)
Optigen Rating
JDCM

DAM
Name of Dam
GM-1
OFA	(hips) (elbows)
CERF
Date of last CERF exam	(MM/DD/YYYY)
Optigen Rating
JDCM

By clicking on the "Submit" button, you are electronically providing this information to the Portuguese Water Dog Club of America for input to the Breeder Referral Program.
	(Start over)

Note: Please send an email if you have any problems with this form.

IMPORTANT: After the litter is whelped and the AKC registration documentation received, all dog information must be submitted to the PWD Litter Database in accordance with Section 7 of the Breeder Agreement.

All Health and Litter information is accepted through the online PWD Health and Litter Database.

The PWD Health and Litter Database Co-Chairs are:
Jane McEwen and Mary Eadie

For questions related to Health - contact PWD H&L Health Admin
For questions related to a Litter - contact PWD H&L Litter Admin

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